Evaluation of lorcaserin for the treatment of obesity

Expert Opin Drug Metab Toxicol. 2013 Aug;9(8):1053-9. doi: 10.1517/17425255.2013.798643. Epub 2013 Jun 26.

Abstract

Introduction: Obesity is an epidemic associated with significant morbidity. Lorcaserin , a novel serotonin 2C receptor antagonist, was recently approved as an adjunct to lifestyle modification for long-term weight loss and maintenance. Clinical studies in patients without diabetes demonstrated 5.8% mean weight loss from baseline with lorcaserin compared to 2.5% with placebo and over twice as many patients achieved ≥ 5% weight loss. Patients with diabetes achieved mean weight loss of 4.5% with lorcaserin compared to 1.5% with placebo as well as modest improvements in glycemic outcomes.

Areas covered: The authors review the pharmacology and clinical efficacy as well as the safety and tolerability of lorcaserin. This was achieved through a PubMed search (1960 - present) on lorcaserin to generate the key literature in the area. The lorcaserin package insert and Food and Drug Administration briefing documents were also used to identify relevant information. To assess long-term clinical efficacy and safety, the authors used studies with a minimum duration of one year.

Expert opinion: Lorcaserin induces moderate but significant weight loss compared to placebo as an adjunct to lifestyle modification. Although head-to-head comparison trials are not available, lorcaserin is likely less effective but better tolerated than its recently approved competitor, phentermine/topiramate. Cardiovascular outcome data will be invaluable in determining lorcaserin's eventual utilization and place in therapy.

Publication types

  • Review

MeSH terms

  • Benzazepines / administration & dosage*
  • Benzazepines / pharmacokinetics*
  • Clinical Trials, Phase III as Topic
  • Drug Interactions
  • Fructose / analogs & derivatives
  • Fructose / pharmacology
  • Humans
  • Obesity / drug therapy*
  • Randomized Controlled Trials as Topic
  • Receptor, Serotonin, 5-HT2C / drug effects
  • Topiramate
  • Weight Loss / drug effects

Substances

  • Benzazepines
  • Receptor, Serotonin, 5-HT2C
  • Topiramate
  • Fructose
  • lorcaserin