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A New Drug That Fights 2 Bad Habits

Still in clinical trials, rimonabant curbs smoking and weight gain

THURSDAY, Aug. 5, 2004 (HealthDayNews) -- A new drug that goes by the name of rimonabant tackles two of the most unhealthy habits known to humans -- smoking and overeating -- and it's getting cautious accolades from experts.

"A drug that potentially lowers two types of repetitive behaviors -- maintaining obese weight and also smoking -- is a drug that has interesting properties. While it isn't a magic bullet, it certainly does seem to be effective in both arenas," said American Heart Association President-Elect Dr. Robert H. Eckel.

Earlier this year, Sanofi-Synthelabo Inc., the French maker of the double-whammy drug, released two studies suggesting rimonabant (brand name ACOMPLIA) could help smokers quit while helping them stay trim at the same time. It is currently awaiting U.S. Food and Drug Administration approval.

In one study, more than 1,000 overweight subjects took either daily doses of rimonabant or a placebo for one year while dieting.

The study's Canadian researchers reported that while the placebo group lost an average of 5 pounds during the year, those on rimonabant dropped 20 pounds on average, or about 10 percent of their body weight. The drug was also associated with improvements in blood levels of cholesterol and triglycerides, a dangerous blood fat.

A second study looked at the drug's effects on smoking cessation. In that study, nearly 800 heavy smokers intent on quitting received either daily rimonabant or a placebo for 10 weeks. Longer-term results are forthcoming, but according to the researchers, 28 percent of those on rimonabant stayed away from cigarettes for at least a month, compared to just 16 percent of those on placebo.

What's more, those who quit while using rimonabant tended to experience none of the weight gain usually associated with smoking cessation, while some even lost weight. Side effects were minimal, the researchers added.

Rimonabant is the first of a new class of drugs that act to block the brain's endocannabinoid system, thought to be responsible for a range of cravings, including those for food and nicotine.

Commenting on the studies, Dr. Norman Edelman, of the American Lung Association, said his group "always welcomes news of new smoking-cessation aids and from these preliminary data this one looks promising." Smoking is by far the leading cause of the number one killer cancer, lung cancer, and it's also linked to other lung conditions such as emphysema and chronic obstructive pulmonary disorder (COPD).

Lung cancer was also on the mind of Dr. LaMar McGinnis, a senior medical consultant at the American Cancer Society. "We are excited about the potential for this, but we are in a wait-and-see mode," he said, stressing that more study on the long-term effects of rimonabant are needed.

Leslie Hare, a representative of Sanofi-Synthelabo, said those studies are currently under way, with new findings to be released later this summer.

Eckel stressed that rimonabant isn't a "miracle drug," however. "The amount of weight reduction with this drug isn't that impressive," he said. "It's modest to moderate, like that seen with other appetite suppressants such as Xenical, other drugs that are out there for weight reduction."

Eckel also noted that rimonabant didn't help everyone to quit smoking. "Some people didn't respond, and some people just cut back modestly on their smoking. So this isn't a magic bullet," he said.

Still, any pharmaceutical advance that could help reduce the 800,000 heart disease- and cancer-related deaths attributed to smoking and obesity in the United States each year is welcome news, Eckel said. He believes rimonabant may some day have an important role to play in curbing both smoking and weight gain.

"It appears to be a helpful adjunct to the other options we have available," he said.

More information

For help on quitting smoking, visit the American Cancer Society.

SOURCES: Robert H. Eckel, M.D., president-elect, American Heart Association, and professor, medicine, University of Colorado, Denver; Norman Edelman, M.D., scientific advisor, American Lung Association; LaMar McGinnis, M.D., senior medical consultant, American Cancer Society; Leslie Hare, spokeswoman, Sanofi-Synthelabo Inc., Paris; March 10, 2004, presentations, American College of Cardiology annual meeting, New Orleans
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