- The Washington Times - Wednesday, March 10, 2004

Soon, one pill could be used to treat the nation’s top two causes of preventable death: smoking and obesity.

New university studies suggest the experimental drug, rimonabant, which could be ready for marketing approval next year, could tackle the two conditions, which are the leading causes for both cardiovascular disease and cancer in the United States.

Together, smoking and obesity account for about 835,000 deaths in the United States annually. Federal health officials announced Tuesday that obesity is fast approaching tobacco as the top underlying cause of preventable death.

“The potential is very large here. … This drug could have a major impact” on national health, Dr. Lowell Dale, associate professor of medicine at the Mayo Clinic and associate medical director of the clinic’s Nicotine Dependence Center, said yesterday in a telephone interview.

Dr. Dale was a principal investigator in an 11-site study that examined the effect of rimonabant in heavy smokers. Study participants had been smoking an average of 20 years and smoked at least one pack per day when they enrolled, he said.

That research determined that rimonabant helped smokers double their odds of kicking the habit in 10 weeks, compared with those who received a placebo. The benefit was seen in smokers given 20 milligrams per day of rimonabant. Those who received only 5 milligrams of the drug “were no better” with smoking cessation than those given dummy pills, Dr. Dale said.

The large study, which involved the U.S. Food and Drug Administration, also found that overweight smokers lost about a pound of fat during the same 10-week period. In contrast, those who received placebos gained an average of two pounds, he said.

In a separate study at the University of Pennsylvania, rimonabant also showed its effectiveness as a weight-control drug. Research found that rimonabant helped overweight people lose 20 pounds in one year; increased levels of so-called good cholesterol; and reduced triglycerides, or fatty substances, in the bloodstream.

Dr. Dale called the weight-loss results of the various studies “superb,” given that smoking cessation is normally associated with weight gain. He noted that smokers in his 10-week study who were not overweight did not gain weight during the study period.

The promising findings were reported this week at a conference in New Orleans of the American College of Cardiology.

According to the University of Cincinnati, which also was involved in the smoking study, rimonabant binds to endocannabinoid receptors in the brain and blocks hormonelike substances produced in the body that can be disrupted when someone smokes or overeats. By blocking the receptors, the drug reduces overweight people’s urge to eat and smokers’ urge to light up.

In addition, an article that appears in NIDA Notes, a publication of the National Institute on Drug Abuse, reports that a drug used primarily to delay the progression of Parkinson’s disease called selegiline, can help smokers who want to quit but has been unsuccessful with other treatments.

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