Efficacy of orlistat vs placebo in the improvement of lipid profile among overweight and obese patients: a meta-analysis
C. Malong, J. Delgado & E. Cunanan
Background: According to the 6th National Nutrition Health Survey, the Filipino is generally unfit, with increasing incidences of major risk factors for cardiovascular disease like hypertension, abnormal lipid profile, obesity and diabetes over the last 5 years. Orlistat, a lipase inhibitor is one of the medications used to facilitate weight loss in obese patients. Given that weight loss is known to be associated with an improvement in the serum lipid profile, concurrent improvement in concentrations of cholesterol and triacylglycerols should result from therapy with orlistat.
Objective: To determine the efficacy of orlistat compared with placebo in lowering lipid levels among overweight and obese patients with or without other comorbidities
Methodology: We performed a systematic literature search of Randomized Controlled Trials (RCTSs) using MEDLINE, Cochrane Library Cochrane Register of Controlled Trials, ScienceDirect, and Herdin from inception to 2008. Manual searching was also done through reviews of bibliographies of previous meta-analysis for orlistat. RCTs comparing orlistat and placebo reporting mean changes from baseline in serum lipid levels in both overweight and obese patients were included.
Results: A total of seven (7) RCTs met out inclusion criteria. All studies compared patients receiving orlistat 120 mg/tab TID with placebo. Statistically significant improvement in mean change from baseline levels of total cholesterol (mean difference was −0.33 (95% CI −0.45, −0.42)), low density lipoprotein (mean difference was −0.28 (95% CI −0.36, −0.19) and trigylceride (mean difference was −0.13 (95% CI −0.19, −0.06)) was seen in orlistat group than the placebo, but no statistically significant improvement in mean change from baseline level in high density lipoprotein (mean difference was −0.03 (95% CI −0.05, −0.02)).
Conclusion: Orlistat produces statistically significant improvement in total cholesterol, low density lipoprotein and triglyceride levels in overweight and obese patients.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.