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Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis.

Stauffer VL, Lipkovich I, Hoffmann VP, Heinloth AN, McGregor HS, Kinon BJ - BMC Psychiatry (2009)

Bottom Line: Predictors/correlates of weight loss > or = 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates.Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain > or = 1 kg.The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neuroscience, Lilly USA, LLC, Indianapolis, IN 46285, USA. Stauffer_Virginia@Lilly.com

ABSTRACT

Background: This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions.

Methods: Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI) > or = 25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n = 68), sibutramine (n = 42), or amantadine (n = 48). Individual patients were analyzed for categorical weight loss > or= 2 kg and weight gain > or = 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale.

Results: Predictors/correlates of weight loss > or = 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain > or = 1 kg.

Conclusion: The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy.

Trial registration: This analysis was not a clinical trial and did not involve any medical intervention.

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Related in: MedlinePlus

Time to weight loss/gain. 1a) Kaplan-Meier estimates of cumulative probability for weight loss ≥ 2 kg, by study. 1b) Kaplan-Meier estimates of cumulative probability for weight gain ≥ 1 kg, by study.
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Figure 1: Time to weight loss/gain. 1a) Kaplan-Meier estimates of cumulative probability for weight loss ≥ 2 kg, by study. 1b) Kaplan-Meier estimates of cumulative probability for weight gain ≥ 1 kg, by study.

Mentions: Analysis of weight outcomes within the individual studies revealed that the highest percentage of patients who experienced successful weight loss at any time (42.9%; 18/42) was in the sibutramine study, while the highest percentage of patients who showed successful weight loss sustained to endpoint (33.3%; 16/48) was in the amantadine study. The highest percentages of weight gain were observed in the nizatidine study, with 70.2% (47/67) of patients showing weight gain at any time and 59.7% (40/67) whose weight gain was sustained to endpoint (Table 3). Figure 1 illustrates the time to weight loss (Figure 1a) and to weight gain (Figure 1b) in the individual study populations. While Figure 1 summarizes the results, it is not intended to suggest direct comparisons of the efficacies of the different weight mitigating agents used in our analyses.


Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis.

Stauffer VL, Lipkovich I, Hoffmann VP, Heinloth AN, McGregor HS, Kinon BJ - BMC Psychiatry (2009)

Time to weight loss/gain. 1a) Kaplan-Meier estimates of cumulative probability for weight loss ≥ 2 kg, by study. 1b) Kaplan-Meier estimates of cumulative probability for weight gain ≥ 1 kg, by study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2667505&req=5

Figure 1: Time to weight loss/gain. 1a) Kaplan-Meier estimates of cumulative probability for weight loss ≥ 2 kg, by study. 1b) Kaplan-Meier estimates of cumulative probability for weight gain ≥ 1 kg, by study.
Mentions: Analysis of weight outcomes within the individual studies revealed that the highest percentage of patients who experienced successful weight loss at any time (42.9%; 18/42) was in the sibutramine study, while the highest percentage of patients who showed successful weight loss sustained to endpoint (33.3%; 16/48) was in the amantadine study. The highest percentages of weight gain were observed in the nizatidine study, with 70.2% (47/67) of patients showing weight gain at any time and 59.7% (40/67) whose weight gain was sustained to endpoint (Table 3). Figure 1 illustrates the time to weight loss (Figure 1a) and to weight gain (Figure 1b) in the individual study populations. While Figure 1 summarizes the results, it is not intended to suggest direct comparisons of the efficacies of the different weight mitigating agents used in our analyses.

Bottom Line: Predictors/correlates of weight loss > or = 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates.Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain > or = 1 kg.The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neuroscience, Lilly USA, LLC, Indianapolis, IN 46285, USA. Stauffer_Virginia@Lilly.com

ABSTRACT

Background: This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions.

Methods: Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI) > or = 25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n = 68), sibutramine (n = 42), or amantadine (n = 48). Individual patients were analyzed for categorical weight loss > or= 2 kg and weight gain > or = 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale.

Results: Predictors/correlates of weight loss > or = 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain > or = 1 kg.

Conclusion: The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy.

Trial registration: This analysis was not a clinical trial and did not involve any medical intervention.

Show MeSH
Related in: MedlinePlus