Health-related quality of life in randomized controlled trials of lorcaserin for obesity management: what mediates improvement?

Clin Obes. 2017 Dec;7(6):347-353. doi: 10.1111/cob.12207. Epub 2017 Aug 17.

Abstract

Lorcaserin, plus diet and exercise, has demonstrated significant weight loss and improved cardiometabolic parameters vs. placebo in patients with overweight/obesity in three randomized, placebo-controlled trials. We examined whether lorcaserin is also associated with greater improvements in health-related quality of life (HRQOL) and whether these improvements are wholly attributable to weight loss. Pooled data from Behavioral Modification and Lorcaserin for Overweight and Obesity Management (BLOOM), Behavioral Modification and Lorcaserin Second Study for Obesity Management (BLOSSOM) and BLOOM-Diabetes Mellitus (BLOOM-DM) trials were analysed (n = 5624). HRQOL was assessed at baseline and 52 weeks using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. Multiple mediation analyses were conducted to evaluate the mechanisms underlying improved HRQOL. Greater HRQOL improvements were observed at 52 weeks in lorcaserin vs. placebo (P < 0.0001). A greater percentage of lorcaserin patients (54.1%) experienced meaningful improvements in IWQOL-Lite total score than placebo patients (48.2%) (P < 0.001). Body mass index (BMI) reduction was the primary driver of improved HRQOL (P < 0.0001), with depressive symptoms and total cholesterol also playing a role (P < 0.05). Improved HRQOL varied by gender, age, race and presence of diabetes and other comorbidities. Lorcaserin treatment significantly improves HRQOL compared with placebo. Although BMI reduction accounts for the majority of these improvements, improvement in depressive symptoms and total cholesterol are contributing factors.

Keywords: Health-related quality of life; Impact of Weight on Quality of Life-Lite (IWQOL-Lite); lorcaserin; mediation analysis.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Obesity Agents / administration & dosage*
  • Benzazepines / administration & dosage*
  • Body Mass Index
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / drug therapy*
  • Obesity / physiopathology
  • Obesity / psychology
  • Quality of Life
  • Weight Loss / drug effects
  • Young Adult

Substances

  • Anti-Obesity Agents
  • Benzazepines
  • lorcaserin