Takeaway
- In patients with obesity, treatment with orlistat was associated with lower rates of overall major adverse cardiovascular events (MACE), myocardial infarction (MI), ischaemic stroke (IS), and new-onset heart failure (HF) and chronic kidney disease stage 3+ (CKD3+), and mortality.
Why this matters
- Despite the established efficacy of orlistat in achieving weight loss in patients with obesity, there is limited evidence quantifying its long-term effect on cardiovascular outcomes.
Study design
- A nation-wide, propensity-score matched cohort study of 73 752 patients with obesity from the UK Clinical Practice Research Datalink (CPRD).
- 36,876 orlistat-treated patients with obesity were matched (1:1) with control participants who had not taken orlistat during the median follow-up 6 years.
- Primary outcome: MACE (composite of fatal or non-fatal MI and IS).
- Secondary outcomes: MACE individual components, new-onset HF and CKD3+, coronary revascularisation, and all-cause mortality.
- Funding: None disclosed.
Key results
- During the median study follow-up of 6 years, orlistat vs control group had lower rates of MACE (HR, 0.74; 95% CI, 0.66-0.83; P<.001).
- Similarly, orlistat vs control group had lower rates of (HR; 95% CI):
- fatal or non-fatal MI (0.77; 0.66-0.88) and IS (0.68; 0.56-0.84; P<.001 for both);
- new-onset HF (0.79; 0.67-0.94; P=.007) and CKD3+ (0.78; 0.73-0.83; P<.001); and
- all-cause mortality (0.39; 0.36-0.41; P<.001).
- No significant difference was seen in revascularization rates between both the 2 groups (HR, 1.12; 95% CI, 0.91-1.38; P=.27).
Limitations
- Retrospective design.
- Risk of bias.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
