Combination therapy with naltrexone and bupropion for obesity reduces total and visceral adiposity

• Published in: Diabetes, obesity & metabolism Vol. 15; no. 9; pp. 863 - 866
• Main Authors: Smith, S. R., Fujioka, K., Gupta, A. K., Billes, S. K., Burns, C., Kim, D., Dunayevich, E., Greenway, F. L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-09-2013; Wiley Subscription Services, Inc
• Subjects: Absorptiometry, Photon; Adipose tissue; Adiposity - drug effects; Analysis of Variance; antiobesity drug; Body composition; Body Composition - drug effects; Body fat; Body weight loss; Bupropion; Bupropion - administration & dosage; Bupropion - therapeutic use; clinical trial; Computed tomography; Dopamine Uptake Inhibitors - administration & dosage; Dopamine Uptake Inhibitors - therapeutic use; Drug Therapy, Combination; Female; Humans; Intra-Abdominal Fat - drug effects; Male; Middle Aged; Naltrexone; Naltrexone - administration & dosage; Naltrexone - therapeutic use; Obesity; Obesity - drug therapy; obesity therapy; Placebos; Tomography, X-Ray Computed; Treatment Outcome; Weight Loss - drug effects; weight loss therapy; clinical trial; adipose tissue; weight loss therapy; body composition; antiobesity drug; obesity therapy
• ISSN: 1462-8902; 1463-1326
• DOI: 10.1111/dom.12095

The effects of combination naltrexone/bupropion therapy on body composition and visceral adipose tissue (VAT) mass were examined in a subset (n = 107) of obese subjects from a Phase 2 trial that compared the efficacy and safety of placebo, naltrexone monotherapy, bupropion monotherapy or one of three naltrexone/bupropion dose combinations for 24 weeks. Body composition data were obtained using dual‐energy X‐ray absorptiometry and computed tomography. Eighty subjects completed the substudy. Naltrexone/bupropion resulted in weight loss and a greater reduction in body fat (−14.0 ± 1.3%) than placebo (−4.0 ± 2.0%), naltrexone monotherapy (−3.2 ± 2.5%) and bupropion monotherapy (−4.1 ± 2.9%; all p < 0.01). Reduction in VAT mass was also greater with naltrexone/bupropion (−15.0 ± 1.8%) than placebo (−4.6 ± 2.7%), naltrexone monotherapy (−0.1 ± 3.5%) and bupropion monotherapy (−2.3 ± 4.2%; all p < 0.01). Reductions in body fat and VAT mass with naltrexone/bupropion were proportional with weight loss. Weight loss with naltrexone/bupropion was not associated with a greater relative reduction in lean mass than placebo or the monotherapies.