Effects of orlistat, alone or combined with hypolipidemic drugs, on cardiovascular risk factors

Orlistat, an antiobesity drug with well-documented efficacy in weight reduction and maintenance, has beneficial effects on metabolic variables. It reduces the incidence of Type 2 diabetes in patients with impaired glucose tolerance and decreases LDL-C levels to a greater degree than expected from weight loss alone. Orlistat is a useful therapy in overweight and obese subjects with cardiovascular risk factors. The combination of orlistat with statins, fenofibrate and ezetimibe led to greater reductions of LDL-C levels compared with each monotherapy. The combination of orlistat with fenofibrate or ezetimibe also further decreased the concentration of atherogenic, small, dense LDL-C, as well as total plasma lipoprotein-associated phospholipase A2 activity, and improved several cardiovascular risk factors compared with monotherapy. However, studies investigating the combination of orlistat with other hypolipidemic drugs only included a small number of subjects with hyperlipidemia or the metabolic syndrome.