Early results of two Phase III studies with Sanofi-Synthelabo’s Acomplia (rimonabant), the first in a new class of therapeutics called Selective CB1 Blockers, indicate that overweight/obese patients with untreated dyslipidemia (high triglycerides and/or high total cholesterol/HDL cholesterol ratio) lost weight in one year while improving their lipid and glucose profiles, and that smokers who had previously unsuccessfully tried to quit smoking, were able to quit in 10 weeks without post cessation weight gain.

“Obesity and smoking are dangerous diseases that are reaching epidemic proportions around the world and are well known risk factors for cardiovascular diseases,” said Chris Cannon M.D., Associate Professor of Medicine at Harvard Medical School and Associate Physician in the Cardiovascular Division of Brigham and Women’s Hospital, Boston. “In addition, they frequently cluster with other metabolic risk factors such as dyslipidemia and diabetes. These results appear to show that rimonabant could become an important agent in the management of cardiovascular risk in these patient populations.”

What these risk factors have in common is that they all seem to be related to an over-stimulated Endocannabinoid System (EC System), a natural physiological system believed to play a role in maintaining energy balance through the regulation of food intake and energy expenditure. The EC system is also believed to play a role in tobacco dependence.

In overweight/obese people, excessive eating and fat accumulation is associated with over- activation of the EC System, which also becomes unbalanced with chronic tobacco use. This leads to a series of signals transmitted by a receptor found in the EC System, the CB1 receptor, which can be found in the brain and in other parts of the body (i.e. adipose tissue or “fat cells” which are involved in lipid and glucose metabolism). Acomplia works by selectively blocking CB1 receptors, helping to normalize the disrupted EC System. In overweight/obese people, this is thought to result in weight loss, reduced waist circumference and improvement of lipid and glucose metabolism. In those that smoke, Acomplia is thought to help people to stop smoking without significant post-cessation weight gain.