ORLISTAT IN OBESITY

A rapid and systematic review of the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity

Background

Obesity is associated with an increased risk of co-morbidity, including cardiovascular disease and diabetes. Following the withdrawal of fenfluramine and dexfenfluramine, interest has focused on a novel anti-obesity drug orlistat. The aim of this review was to systematically assess the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity.

Findings

Although many trials have demonstrated statistically significant differences between groups in terms of weight loss in favour of orlistat versus placebo, the differences may not always be of clinical significance. The clinical significance of between-group differences for secondary outcomes may also be debatable. Possible adverse effects should be taken into account when prescribing orlistat, particularly gastrointestinal effects.

Conducted by: S O'Meara1, R Riemsma1, L Shirran1, L Mather1, G ter Riet1,2

1. NHS Centre for Reviews and Dissemination; 2. Department of Epidemiology, University of Maastricht

Further details

Project page on HTA Programme website

Related guidance

Commissioned to inform NICE Technology Appraisal 22: Orlistat for the treatment of obesity in adults. London: National Institute for Clinical Excellence; 2001. NB: This guidance is obsolete and has been replaced by CG43 Obesity

Publications

O'Meara S, Riemsma R, Shirran L, Mather L, ter Riet G. A rapid and systematic review of the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity. Health Technol Assess. 2001;5(18)

O'Meara S, Riemsma R, Shirran L, Mather L, ter Riet G. A systematic review of the clinical effectiveness of orlistat used for the management of obesity. Obes Rev. 2004;5(1):51-68

Presentations

O'Meara S, Riemsma R, Shirran L, Mather L, ter Riet G. Systematic review of orlistat for obesity. ISTAHC Conference; 2001 June; Philadelphia, USA

Funding

Commissioned by the HTA Programme on behalf of NICE