Weight management hasn’t had a safe pharmaceutical alternative since 1999. Approved in June by the U.S. Food and Drug Administration (FDA) after two years of trials, Belviq (lorcaserin) shows promise for obese (BMI of 30 or greater) and overweight (BMI of 27 or greater) adults with weight-related conditions such as type 2 diabetes mellitus (T2DM), hypertension, or high cholesterol. Compared to placebo, patients treated with Belviq were twice as likely to lose weight: 47 percent of non-diabetic patients and 38 percent of patients with type 2 diabetes lost at least 5 percent of their body weight — an average of 12 pounds (5.44 kilograms) — whereas only 23 percent of those on placebo did so.
Specifically designed for use with diet and exercise, Belviq is expected to help patients feel full with smaller food portions by activating the brain’s serotonin 2C receptor. This is similar to weight loss drugs of the late 1990s such as fenfluramine and sibutramine, which were withdrawn because of links to heart valve damage.
The FDA recorded little difference in valve abnormalities between Belviq and placebo but suggests caution for patients with congestive heart failure. The manufacturer, Arena Pharmaceuticals GmbH, will need to evaluate what effect Belviq has on risk of heart attack or stroke.
Users of other serotonin-activating drugs are also cautioned. Mixing Belviq with medications for migraine and depression medication can result in serotonin syndrome, a life-threatening drug condition. Pregnant women should completely avoid this drug. Disturbances in memory or attention have also been noted.
Patients with T2DM experienced better glycemic control. Headache, fatigue and nausea may be common side effects; T2DM patients may suffer additional effects such as hypoglycemia, back pain, and cough. The FDA recommends that users discontinue treatment if they do not lose 5 percent of their body weight in the first 12 weeks.
A huge demand exists on the market for new obesity drugs. According to the U.S. Centers for Disease Control and Prevention, one in three adults is obese.
Dan Kelly / Endocrine News / August 2012