Effect of Orlistat in Obese Veterans at the Brooklyn VA Hospital, Correlation with Weight loss and Hepatotoxicity

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 660-676-Clinical Obesity Treatment
Clinical
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-664
Rajeev Sharma*1, Marianna Antonopoulou1, Nadine Montemarano2, Miriam Cohen3 and Morana Poljak-Varenika3
1SUNY Downstate Medical Center, Brooklyn, NY, 2SUNY Downstate Medical Center, 3VA NY Harbor Healthcare System
Objective: To examine the effect of Orlistat in obese patients at the Brooklyn VA Hospital, with regards to liver toxicity and weight-loss.

Background: Obesity presents one of the biggest health problems the medical system faces today. Management strategies include changes in lifestyle, behavioral therapy and pharmacological options. Orlistat is a medication available for long-term treatment of obesity. Case reports suggest that it may be associated with liver toxicity and in 2010 the FDA approved a revised label to include new safety data about cases of severe liver injury with its use. To date, there have been no large studies demonstrating an association between Orlistat and hepatic dysfunction.

Methods: We conducted a retrospective case control analysis of the effect of Orlistat in obese patients. We included patients on Orlistat who were enrolled in the VA, Brooklyn, NY Managing Overweight/Obesity in Veterans Everywhere (MOVE) clinic from October 2006 to May 2012. Exclusion criteria were significant alcohol consumption, hepatitis, hepatotoxic drugs other than a statin or the use of Orlistat less than six months. All patients were provided education and consultation. Consistency in liver function (LFT) over one year was analyzed with the intraclass correlation coefficient (ICC).  Differences in weight loss were compared between the group treated with Orlistat to that of a matched control group not on Orlistat using t-tests. 

Results: Seventy-two patients were enrolled in the study, thirty-six on Orlistat and thirty-six not on Orlistat. Data were analyzed with SPSS Version 15. There were no differences at baseline between groups in age, gender, race, statin use or Body Mass Index (BMI).  There was a moderately strong agreement among LFT values at baseline, 6-months and one-year (ICC = 0.69). Change in BMI from baseline to 6 months was significant in the Orlistat group (p<0.001), but not in the group receiving education and consultation alone. This change was sustained over one year. In the Orlistat group, statin use had no significant effect on LFT’s.

 Conclusions: Orlistat does not appear to have any direct hepatotoxic effects, as measured by LFTs, over one year of treatment. Patients on Orlistat lost more weight and were able to maintain that weight-loss more effectively than patients treated with education and consultation alone.

Nothing to Disclose: RS, MA, NM, MC, MP

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm