The data for Merck’s obesity drug taranabant is out, and the verdict is: There is no magic bullet for obesity. Taranabant belongs to the same drug class as rimonabant, which is marketed in Europe as Acomplia but has not been approved in the US. Both taranabant and rimonabant cause weight loss by blocking the cannabinoid receptor type 1 (CB1) receptors in the brain – the very receptors that are activated by marijuana. So, in a sense, these drugs do the opposite thing as marijuana. Whereas marijuana is known (theoretically) to cause the “munchies”, these drugs seem to block food craving. There are loads of people who would love to stop desiring food, but there is no “calorie-free lunch” (pun intended).
In clinical trials, rimonabant was linked with depression and suicidality. These side effects have prevented the drug from being approved in the US, although the drug’s maker (Sanofi Aventis) is continuing to study the drug in a large clinical trial in the hopes that it will eventually be approved. Currently it’s being tested in nearly 20,000 people!
So what about taranabant? It appears that the story for taranabant is going to be much the same as rimonabant. In the recently published clinical trial of the drug (earlier this week in JAMA – Arjun from our team was at the American Cardiology Conference where this was presented), depression was a frequently observed side effect. ACK! The side effect profile of the highest dose of the drug was so bad, in fact, that a committee responsible for overseeing the clinical trial (the DSMB) halted the highest dosage arm of the trial mid-way through the clinical trial. That’s not great news, but the manufacturer (Merck, the maker of Januvia) moved on gamely, and got rid of the largest two doses – that was fast! And good, in our view, so patients and doctors and nurses will be less concerned. The smallest dose of the drug had a moderate side effect profile, with 28% of patients experiencing psychiatric adverse events compared to about 20% in the placebo group (we take this to mean the questions were hard to answer if one out of five of the placebo group thought there were problems!).
Overall, weight loss was moderate: patients lost about 2.6 kg (~5.7 pounds) on average, from a baseline of about 100 kg (220 pounds) - a drop of about 4%. Merck has indicated that it only plans to study the smallest dose moving forward. Whether 5.7 pounds is enough is a question that will be examined further … we believe this might well be a drug made for combination use with other drugs, such as Januvia, which is weight neutral. Time will tell!
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Posted by: Affiliate Promotion | 03/20/2009 at 07:40 PM
well i think the obesity need been treated since you are kid
Posted by: Children Anxiety Disorder | 03/20/2009 at 07:35 PM
Very well written article. Thanks for summarizing these important results.
Posted by: Govt | 04/13/2008 at 10:38 PM