As a supplement to a reduced-calorie diet and increased physical activity, lorcaserin is FDA-approved for chronic weight management in the United States. Lorcaserin is a serotonin receptor subtype 5-hydroxytryptamine 2C (5-HT2C), which regulates satiety and food intake. However, diet pills had a history of causing valvular heart disease. When lorcaserin was approved, there was an extensive analysis to show it was safe and did not cause heart disease.
In this study, led by Neil Weissman, MD, the goal of this research was to evaluate the effects of lorcaserin in patients with pre-existing valvulopathy. In other words, if a patient was prescribed this drug and already had heart disease, would it be safe for them to take this drug and will it cause the valvular heart disease to get worse? Published in Obesity, the research was a pooled analysis of data from three Phase III randomized, placebo-controlled, double-blind, multicenter studies.
Valvulopathy is a broad term used for diseases and disorders that affect the heart valves. Valvular abnormalities, including aortic or mitral regurgitation, can be induced by certain drugs. Aortic or mitral regurgitation is leakage of blood backward through the valves of the heart. This leakage can lead to thickening of the heart wall or to the buildup of blood volume and pressure within the heart, resulting in a less effective pump and the possibility of heart failure.
Analyses of the serial echocardiograms obtained at baseline and every 6 months throughout the study (up to 2 years) showed that no association was detected between weight loss and valvular regurgitation. The echocardiograms did show that numerically greater proportions of patients taking lorcaserin compared to the placebo had decreases in aortic (33.0% vs. 28.3%) or mitral (41.3% vs. 36.7%) regurgitation. The researchers concluded that lorcaserin does not adversely affect valvular disease in patients with pre-existing valvulopathy.
Dr. Weissman is president of MedStar Health Research Institute, professor of medicine at Georgetown University School of Medicine and co-director of the Cardiovascular Core Laboratories. His research interests include the use of ultrasound in multicenter trials, particularly as they relate to valvular heart disease.
Obesity, 2017. DOI: 10.1002/oby.21695
