Skip to main content
Top
Published in: Advances in Therapy 1/2019

Open Access 01-01-2019 | Original Research

Reduction of Excessive Visceral Fat and Safety with 52-Week Administration of Lipase Inhibitor Orlistat in Japanese: Long-Term Clinical Study

Authors: Kohji Shirai, Michitaka Tanaka, Toru Fujita, Yuka Fujii, Masatsugu Shimomasuda, Soichi Sakai, Yoshishige Samukawa

Published in: Advances in Therapy | Issue 1/2019

Login to get access

Abstract

Introduction

Orlistat is an inhibitor of pancreatic lipase and is used as an anti-obesity drug in many countries. However, there are no data available regarding the effects of orlistat on visceral fat (VF) accumulation in Japanese individuals. Therefore, this study aimed to analyze the efficacy and safety of 52 weeks of orlistat administration in Japanese individuals.

Methods

Orlistat 60 mg was administered orally three times daily for 52 weeks to Japanese participants with excessive VF accumulation and without dyslipidemia, diabetes mellitus, and hypertension (metabolic diseases). Participants were also counseled to improve their diet and to maintain exercise habits. We defined excessive VF accumulation as a waist circumference (WC) of ≥ 85 cm for males and ≥ 90 cm for females, which corresponds to a VF area of 100 cm2. Adverse reactions, clinical laboratory tests, VF, WC, body weight (BW), etc., were monitored throughout the study period.

Results

VF, WC, and BW were significantly reduced at week 52 from baseline; the mean ± standard error rate of change was − 21.52% ± 1.89%, − 4.89% ± 0.45%, and − 5.36% ± 0.56%, respectively, and continued to reduce throughout the 52 weeks; these significantly reduced at whole term compared with baseline. Most adverse reactions were defecation-related symptoms such as oily spotting and flatus with discharge (flatus with small amounts of stool or oil) due to the pharmacologic effects of the lipase inhibitor. These symptoms were mostly mild, reversible, and recognizable by the participants; none were serious or severe. No participants discontinued by medical judgment about adverse reactions, and the drug could be administered continuously.

Conclusion

VF, WC, and BW were reduced from week 4 to week 52, indicating the effect of long-term orlistat administration. Moreover, it was well tolerated with an acceptable safety profile. Long-term administration of orlistat may be efficacious in reducing VF accumulation with safety when used in combination with diet and exercise.

Trial Registration

This study is registered with the Japan Pharmaceutical Information Center (identifier: JapicCTI-184004).

Funding

Funding for this study was provided by Taisho Pharmaceutical Co., Ltd.
Appendix
Available only for authorised users
Literature
1.
go back to reference Miyazaki S. From obesity and obesity disease to metabolic syndrome. J Ther. 2008;90:1650–4. Miyazaki S. From obesity and obesity disease to metabolic syndrome. J Ther. 2008;90:1650–4.
2.
go back to reference Japan Society for the Study of Obesity. Guidelines for the management of obesity disease. 2016. Life Science Publishing Co.; 2016:1–132. Japan Society for the Study of Obesity. Guidelines for the management of obesity disease. 2016. Life Science Publishing Co.; 2016:1–132.
3.
go back to reference Sassi F. Fit not fat. In: Sassi F (ed) Obesity and the economics of prevention. Cheltehan; 2010. Sassi F. Fit not fat. In: Sassi F (ed) Obesity and the economics of prevention. Cheltehan; 2010.
4.
go back to reference Yumuk V, Frühbeck G, Oppert JM, Woodward E, Toplak H. An EASO position statement on multidisciplinary obesity management in adults. Obes Facts. 2014;7(2):96–101.CrossRef Yumuk V, Frühbeck G, Oppert JM, Woodward E, Toplak H. An EASO position statement on multidisciplinary obesity management in adults. Obes Facts. 2014;7(2):96–101.CrossRef
6.
go back to reference Hiuge-Shimizu A, Kishida K, Funahashi T, et al. Absolute value of visceral fat area measured on computed tomography scans and obesity-related cardiovascular risk factors in large-scale Japanese general population (the VACATION-J study). Ann Med. 2012;44:82–92.CrossRef Hiuge-Shimizu A, Kishida K, Funahashi T, et al. Absolute value of visceral fat area measured on computed tomography scans and obesity-related cardiovascular risk factors in large-scale Japanese general population (the VACATION-J study). Ann Med. 2012;44:82–92.CrossRef
7.
go back to reference Kato A, Muramoto A, Matsushita M, Tsushita K. The relationship between the change of visceral fat area using dual impedance method and the improvement of medical data related to obesity: evaluation of Japanese men in their 20’s and 30’s with obesity who have gone through a life style intervention program. J Jpn Soc Study Obes. 2016;22:117–23. Kato A, Muramoto A, Matsushita M, Tsushita K. The relationship between the change of visceral fat area using dual impedance method and the improvement of medical data related to obesity: evaluation of Japanese men in their 20’s and 30’s with obesity who have gone through a life style intervention program. J Jpn Soc Study Obes. 2016;22:117–23.
8.
go back to reference Umebayashi A, Kanesada Y, Nishikawa H, et al. Relationships between risk factors for metabolic syndrome and visceral fat analyzed by age groups. J Jpn Mibyo Syst Assoc. 2015;21:1–6. Umebayashi A, Kanesada Y, Nishikawa H, et al. Relationships between risk factors for metabolic syndrome and visceral fat analyzed by age groups. J Jpn Mibyo Syst Assoc. 2015;21:1–6.
9.
go back to reference Okauchi Y, Nishizawa H, Funahashi T, et al. Reduction of visceral fat is associated with decrease in the number of metabolic risk in Japanese men. Diabetes Care. 2007;30:2392–4.CrossRef Okauchi Y, Nishizawa H, Funahashi T, et al. Reduction of visceral fat is associated with decrease in the number of metabolic risk in Japanese men. Diabetes Care. 2007;30:2392–4.CrossRef
10.
go back to reference Look AHEAD Research group, Pi-Sunyer X, Blackburn G, et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007;30:1374–83.CrossRef Look AHEAD Research group, Pi-Sunyer X, Blackburn G, et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007;30:1374–83.CrossRef
13.
go back to reference Muramoto A, Matsushita M, Kato A, et al. Three percent weight reduction is the minimum requirement to improve health hazards in obese and overweight people in Japan. Obes Res Clin Pract. 2014;8:e466–75.CrossRef Muramoto A, Matsushita M, Kato A, et al. Three percent weight reduction is the minimum requirement to improve health hazards in obese and overweight people in Japan. Obes Res Clin Pract. 2014;8:e466–75.CrossRef
14.
go back to reference Hiratani M, Nakamura S, Nakanishi S, Kihira E. Effects of specific health instruction: four years hence. J Rural Med. 2015;64:34–40. Hiratani M, Nakamura S, Nakanishi S, Kihira E. Effects of specific health instruction: four years hence. J Rural Med. 2015;64:34–40.
15.
go back to reference Smith SR, Stenlof KS, Greenway FL, et al. Orlistat 60 mg reduces visceral adipose tissue: a 24-week randomized, placebo-controlled, multicenter trial. Obesity. 2011;19:1796–803.CrossRef Smith SR, Stenlof KS, Greenway FL, et al. Orlistat 60 mg reduces visceral adipose tissue: a 24-week randomized, placebo-controlled, multicenter trial. Obesity. 2011;19:1796–803.CrossRef
16.
go back to reference Matsuzawa Y, Kotani K, Tokunaga K. Ideal body weight with the lowest morbidity. J Jpn Soc Study Obes. 1998;4:65–9. Matsuzawa Y, Kotani K, Tokunaga K. Ideal body weight with the lowest morbidity. J Jpn Soc Study Obes. 1998;4:65–9.
18.
go back to reference Hauptman J, Lucas C, Boldrin MN, Collins H, Segal KR. Orlistat in the long-term treatment of obesity in primary care settings. Arch Fam Med. 2000;9:160–7.CrossRef Hauptman J, Lucas C, Boldrin MN, Collins H, Segal KR. Orlistat in the long-term treatment of obesity in primary care settings. Arch Fam Med. 2000;9:160–7.CrossRef
21.
go back to reference Ueno H, Nakazato M. The prospects of novel anti-obesity drugs. J Jpn Soc Internal Med. 2014;103:753–9.CrossRef Ueno H, Nakazato M. The prospects of novel anti-obesity drugs. J Jpn Soc Internal Med. 2014;103:753–9.CrossRef
22.
go back to reference Hu T, Mills KT, Yao L, et al. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol. 2012;176:S44–54.CrossRef Hu T, Mills KT, Yao L, et al. Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol. 2012;176:S44–54.CrossRef
Metadata
Title
Reduction of Excessive Visceral Fat and Safety with 52-Week Administration of Lipase Inhibitor Orlistat in Japanese: Long-Term Clinical Study
Authors
Kohji Shirai
Michitaka Tanaka
Toru Fujita
Yuka Fujii
Masatsugu Shimomasuda
Soichi Sakai
Yoshishige Samukawa
Publication date
01-01-2019
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 1/2019
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-018-0822-x

Other articles of this Issue 1/2019

Advances in Therapy 1/2019 Go to the issue