Pramlintide Helps Obese People Lose Weight

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Sustained weight loss following 12-month pramlintide treatment as an adjunct to lifestyle intervention in obesity, by Steve Smith and colleagues. Diabetes Care 31:1816-1823, 2008

What is the problem and what is known about it so far?

Efforts to develop weight loss drugs have been delayed by safety issues. Amylin, a hormone that, like insulin, comes from the pancreas, has been shown to reduce eating and weight in studies of rats. Pramlintide is a man-made version of amylin that is used with insulin to better control diabetes in some patients. Pramlintide is now being studied as a possible weight loss drug.

Why did researchers do this particular study?

The researchers wanted to find whether different doses of pramlintide would help people who were already following a plan to make healthy lifestyle changes lose weight more easily.

Who was studied?

More than 400 very overweight adults without diabetes were included in the study.

How was the study done?

Subjects all followed the lifestyle program. Some were given pramlintide injections in one of six doses, and others received dummy, or fake, injections before meals. After 4 months, all groups were compared. Subjects who completed the first part of the study could then choose to continue their assigned treatment for 8 more months. Those subjects were compared again at the end of the study year.

What did the researchers find?

After 4 months, those using any dose of pramlintide lost more weight than those receiving the dummy medicine. By 1 year, those taking pramlintide in all but the lowest dose either continued to lose weight or kept weight off, while those receiving the dummy medicine regained the weight they had lost in the early months of the study. Some pramlintide subjects had mild upset stomach that decreased over time, but weight loss occurred in those with and without upset stomach.

What were the limitations of the study?

Some of the subjects who decided to continue their treatment after the first 4 months dropped out of the study before a full year had passed. Also, only subjects who chose to continue after the first 4 months did so and were studied further. This might have influenced the study's findings about how long people can keep off weight they lose using pramlintide.

What are the implications of the study?

Pramlintide may help very overweight people lose weight and keep it off better than lifestyle changes alone. However, this drug is not yet approved for use as a weight loss medicine and more studies are needed.

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