Experimental Weight-Loss Pill Passes Early Test

(HealthDay News) -- Researchers are hoping that an experimental new weight-loss drug will prove to be a valuable new weapon in the crusade against obesity.

In recently released phase 2 trials, the drug, known as lorcaserin, resulted in substantial weight loss in obese men and women.




"Lorcaserin is a completely novel mechanism and we think it can bring very robust weight loss. But, also, the safety profile of the compound is excellent," said Dominic P. Behan, co-founder and chief scientific officer of Arena Pharmaceuticals in San Diego, which makes the drug and sponsored a study published in the Dec. 4 issue of the journal Obesity.

"We demonstrated a highly statistically significant, progressive weight loss. This study involved no diet or exercise and the weight loss was rapid and we saw the weight loss in as little as two weeks," he added.

A phase 3 trial is under way and, if all goes well, Arena Pharmaceuticals may file a new drug application with the U.S. Food and Drug Administration at the end of 2009, Behan said.

With some two-thirds of Americans either overweight or obese, the need for an effective weight loss tool is tremendous. Excess weight can lead to a variety of health problems, including heart disease, stroke, cancer, arthritis and type 2 diabetes.

"Obesity is an epidemic," said Dr. Stuart Weiss, a clinical assistant professor of medicine at New York University's Langone Medical Center in New York City. "Diabetes trails behind obesity by a short few years and the numbers of patients that are developing diabetes is staggering."

Diet and exercise are proven antidotes for excess weight, but few people are able to sustain such changes and, even if they lose weight, will regain it.

Some weight-loss drugs are already on the market -- such as Xenical and Meridia -- but have certain side effects.

The drug Fen-phen, a combination of fenfluramine and dexfenfluramine, worked for many but was withdrawn from the market in 1997 when it was linked with increased rates of heart valve problems in patients.

Fen-phen acted on serotonin receptors both in the brain and in the heart and therein lay the problem, Behan said.

"The challenge was to design a compound that was purely selective for the receptor involved, namely the 2c receptor [located in the hypothalamus region of the brain and involved in weight loss] and avoiding the 2b receptor [located in the heart]," Behan said.

The result was lorcaserin, which targets the 5-HT2C serotonin receptor only.

For the phase 2 trial, 469 men and women with a body mass index ranging from 30 to 45 were randomly assigned to one of four groups: 10 milligrams (mg) of lorcaserin once a day, 15 mg once a day, 10 mg twice a day, or a placebo.

Participants taking lorcaserin at 10 mg, 15 mg and 20 mg a day lost 4 pounds, 5.7 pounds and 7.9 pounds, respectively, over the 12-week period. Those in the placebo group lost less than a pound.

In the 10 mg, 15 mg and 20 mg groups, respectively, 12.8 percent, 19.5 percent and 31.2 percent of participants lost 5 percent or more of their starting body weight, versus only 2.3 percent of patients on the placebo.

Participants taking the two higher doses of lorcaserin also shaved inches off their waist and dropped their cholesterol levels.

Also, their echocardiograms -- ultrasound images of the heart -- were normal.

"It [lorcaserin] certainly looks a bit better [than other weight-loss medications]," Weiss said. "We don't have much out there. They're really just modest medications and they don't do much at all."

More information
Visit the U.S. Centers for Disease Control and Prevention for more on overweight and obesity.

Cancer Deaths Take Heavy Financial Toll

(HealthDay News) -- In pure economic terms of productivity lost and the expense of care-giving, cancer deaths cost the United States $232.4 billion in 2000 and will cost $308 billion in 2020, a new report finds.

But another way of measuring that toll includes the human element of years of life lost -- and that model placed the cost of cancer mortality at $960.7 billion in 2000 and projects it to reach $1.472 trillion in 2020.

Those two estimates appear in side-by-side papers published online Dec. 9 in the Journal of the National Cancer Institute. While the numbers differ widely, they are alike in one major respect, said Cathy J. Bradley, a professor of health administration at Virginia Commonwealth University and the Massey Cancer Center in Richmond, Va., and lead author of one of the reports.

"In both cases, the percentage of cost caused by lung cancer was about the same," Bradley said. "Lung cancer accounts for between a quarter and a third of the value of life lost."

The assessment made by Bradley and her colleagues used what is called the human capital approach, which looks strictly at money not earned or money spent because of cancer deaths. Lost productivity cost the country $115.8 billion in 2000. Adding in the cost of care-giving and lost household duties, as well as the loss of regular wage-earning jobs, more than doubled the total of that reckoning.

Robin Yabroff, an epidemiologist at the U.S. National Cancer Institute, and lead author of the second paper, said her "calculation was based on willingness to pay. How much would an individual be willing to pay for an extra year of life?"

Estimates of that figure can vary, depending on the country. The Canadian government, for instance, has set the value of an added year of life at $50,000, a figure it uses to determine whether the national health program will pay for drug treatment, Bradley said. Her report used previous U.S. studies to set the value of an added year of life at $150,000. That estimate led to the $960.7 billion cost for the year 2000.

"Both of these methods are used in the medical literature," Yabroff said. "We thought it would be useful to compare them."

Large as the costs are, they reflect a decrease in the incidence of cancer in the United States. A report issued earlier this month said the rate for all cancers among men and women had dropped 0.8 percent a year between 1999 and 2005 -- a 1.8 percent a year decline for men and a 0.6 percent annual decline for women.

The human capital approach places a higher value on some people than others, Bradley added. For example, "Certain diseases inflict a lower cost because they affect older people more," she said. "Men tend to be valued higher than women, men in their middle years higher than men at the beginning of their career."

The findings could be used to affect cancer spending priorities, Bradley said.

"Policy makers have to decide if we focus on working-age individuals, if we focus on prevention or treatment," she said. "If you get people to stop smoking, 40 years later you see the cost of lung cancer come down. Or perhaps right now you would want to make an impact on treatment."



The assessment of cost is important because "it puts a dollar value on the fact that many people die of cancer at a younger age," Yabroff said.

"But," Bradley added, "you can argue that people are worth more than the wages they earn."

More information
The American Cancer Society has statistics on U.S. cancer deaths.

How the Body Works : The Digestive System

Starting at the mouth, the digestive system helps provide the energy your body needs to perform its many functions. Upon entry into a person's mouth, the teeth cut, tear, crush and grind food. In the mouth, salivary glands respond to the thought or presence of food by producing a fluid containing mucus and the enzymes amylase and maltase. The tongue then mixes the food and rolls it into a soft ball, called the bolus, which is pushed toward the esophagus. Passing through the esophagus the bolus is dropped into the stomach where gastric glands, one secreting digestive enzymes and the other secreting hydrochloric acid, begin to break the food down into smaller pieces. The stomach wall discharges mucus during this phase to protect itself against the action of the gastric acid. From there the food passes into the small intestine through the phylorus, a sphincter muscle that controls the flow of food. It is in the small intestine where a major part of digestion and absorption occurs. The intestinal wall releases enzymes which digest proteins, fats and carbohydrates. Blood and lymph vessels, which supply the small intestine, take away the final products of digestion. The lymphatics transport the fats around the body and finally release them into the bloodstream. Blood takes sugars and amino acids to the liver via the portal vein. The pancreas, like the small intestine, secretes enzymes in an alkaline juice to digest proteins, fats and carbohydrates. It also manufactures hormones which regulate the blood sugar level. From the small intestine, the digested food is received by the liver, which manufactures bile for the gall bladder. The gall bladder stores and discharges the bile, which helps to break down fats into minute droplets. Undigested food from the small intestine is then passed into the large intestine. There blood vessels supplying the large intestine carry away water extracted from the undigested waste. After passing through to the large intestine the ileocecal valve prevents digested food from returning to the small intestine. Undigested food is eliminated from the system through the anus.