A Long Term Study of Sibutramine and the Role of Obesity Management in Relation to Cardiovascular Disease in Overweight and Obese Patients (SCOUT)

• ClinicalTrials.gov Identifier: NCT00234832
• Recruitment Status: Completed
• First Posted: October 10, 2005
• Results First Posted: April 15, 2010
• Last Update Posted: May 11, 2010
• Sponsor: Abbott
• Information provided by: Abbott

Study Description

Brief Summary:

The purpose of the study was to determine the long-term effect of sibutramine treatment on cardiovascular outcomes in overweight and obese patients at risk of a cardiovascular event.

Condition or disease	Intervention/treatment	Phase
Obesity	Drug: Sibutramine hydrochloride; Drug: Placebo	Phase 3

Detailed Description:

The study consisted of 4 periods: 1) a Screening Period of approximately 2 weeks; 2) a 6-week Lead-in Period, during which subjects received single-blind sibutramine and country-specific standard of care for weight management. Subjects who discontinued study drug treatment during the Lead-in Period were not randomized and did not participate in the double-blind Treatment Period or the Follow-up Period; 3) a double-blind Treatment Period in which subjects were randomized to 1 of the 2 treatment groups and were followed until the study ended; and 4) a double-blind Follow-up Period, during which randomized subjects who discontinued study drug were followed until the study ended. The Randomization Phase consisted of the double-blind Treatment Period and the double-blind Follow-up Period. Subjects received country-specific standard of care for weight management during the Randomization Phase.

An independent events adjudication committee evaluated all potential cardiovascular outcome events and confirmed the outcome events and time of onset to be included in the statistical analyses.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 10777 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Treatment
• Official Title: Sibutramine Cardiovascular Morbidity/Mortality Outcomes Study in Overweight or Obese Subjects at Risk of a Cardiovascular Event
• Study Start Date: January 2003
• Actual Primary Completion Date: March 2009
• Actual Study Completion Date: November 2009

Arms and Interventions

Arm	Intervention/treatment
Experimental: Sibutramine; Subjects were randomized to receive sibutramine 10 mg once daily (QD) during the Treatment Period after a 6-week Lead-in Period	Drug: Sibutramine hydrochloride; One 10 mg tablet QD plus country-specific standard care for weight management. (During the Treatment Period, the dose could have been titrated up to 15 mg at the investigator's discretion.); Other Names: ABT-991; sibutramine; Meridia; Reductil
Placebo Comparator: Placebo; Subjects were randomized to receive placebo QD during the Treatment Period after a 6-week Lead-in Period	Drug: Placebo; 1 tablet QD plus country-specific standard care for weight management (During the Treatment Period, the dose could have been titrated up to 15 mg at the investigator's discretion.)
Experimental: Lead-in sibutramine; All subjects received 10 mg sibutramine QD during a 6-week Lead-in Period	Drug: Sibutramine hydrochloride; 10 mg tablet QD during the 6-week Lead-in Period plus country-specific standard care for weight management

Outcome Measures

Primary Outcome Measures :

1. Risk of Experiencing a Primary Outcome Event (POE) (i.e., Nonfatal Myocardial Infarction [MI], Nonfatal Stroke, Resuscitated Cardiac Arrest, Cardiovascular [CV] Death) [ Time Frame: From randomization up to 6 years ]
   For each subject, POE status (with/without an event) and time to first occurrence of a POE using time-to-event analysis were evaluated. All POE confirmed by an independent adjudication committee were included in the analysis.

Secondary Outcome Measures :

1. Risk of Death From Any Cause (All-cause Mortality) [ Time Frame: From randomization up to 6 years ]
   For each subject who died, the time to death was evaluated using time-to-event analysis.
2. Risk of Experiencing a POE or a Revascularization Procedure [ Time Frame: From randomization up to 6 years ]
   This outcome includes nonfatal MI, nonfatal stroke, resuscitated cardiac arrest, CV death (including events such as fatal MI and fatal stroke), and any of the following revascularization procedures: percutaneous transluminal coronary angioplasty, coronary artery bypass graft, coronary artery stent placement, cardiac transplant, peripheral vascular bypass or angioplasty, and carotid endarterectomy. For each subject, the POE or revascularization status (yes/no) and time to first occurrence of an event using time-to-event analysis were evaluated.
3. Risk of Experiencing a Nonfatal MI Included in the POE [ Time Frame: From randomization up to 6 years ]
   For each subject, the first occurrence of a nonfatal MI included in the POE was evaluated using time-to-event analysis.
4. Risk of Experiencing a Nonfatal Stroke Included in the POE [ Time Frame: From randomization up to 6 years ]
   For each subject, the time to first occurrence of a nonfatal stroke included in the POE was evaluated using time-to-event analysis.
5. Risk of Experiencing a Resuscitated Cardiac Arrest Included in the POE [ Time Frame: From randomization up to 6 years ]
   For each subject, the time to first occurrence of a resuscitated cardiac arrest included in the POE was evaluated using time-to-event analysis.
6. Risk of Experiencing Cardiovascular Death Included in the POE [ Time Frame: From randomization up to 6 years ]
   For each subject, the time to cardiovascular death included in the POE was evaluated using time-to-event analysis.

Eligibility Criteria

• Ages Eligible for Study: 55 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Subject's body mass index (BMI) was >= 27 kg/m(2) and <= 45 kg/m(2) or their BMI was >= 25 kg/m(2) and < 27 kg/m(2) with waist circumference of >= 102 cm in males or >= 88 cm in females.

• Medical history positive for:

  • Preexisting cardiovascular disease (i.e., coronary artery disease, cerebrovascular disease, or peripheral arterial occlusive disease) and/or
  • Type 2 diabetes mellitus with at least 1 other risk factor (i.e., dyslipidemia, controlled hypertension, current smoker, or diabetic nephropathy with evidence of microalbuminuria)

Exclusion Criteria:

• History of recent myocardial infarction.
• Heart failure symptoms greater than New York Heart Association Functional Class II.
• Hemodynamically significant valvular or left ventricular (LV) tract obstruction.

• Subjects without a pacemaker and with any of the following:

  • Sinus bradycardia (< 50 bpm)
  • Sick sinus syndrome
  • Atrioventricular block of more than 1st degree
• Mean sitting systolic blood pressure (SBP) > 160 mmHg. Mean sitting diastolic blood pressure (DBP) > 100 mmHg. Mean sitting heart rate (HR) > 100 bpm.
• Syncopal episodes presumed to be due to uncontrolled life-threatening arrhythmias.
• Planned cardiac surgery or coronary angioplasty within 6 months of screening.
• History of recent non-hemorrhagic stroke or transient ischemic attack (TIA), history of hemorrhagic stroke.
• Hyperthyroidism.
• Known chronic liver disease or endstage renal disease.
• Severe, symptomatic benign prostatic hyperplasia which may require surgery.
• Known pheochromocytoma, history of narrow angle glaucoma, Gilles de la Tourette syndrome, history of seizures, history of bariatric or abdominal obesity surgery (excluding liposuction).
• Concomitant use of monoamine oxidase inhibitors or drugs that increase levels of serotonin in the brain.
• Treated hypertension stabilized for less than 3 months.
• Inability to perform regular physical activity.

Contacts and Locations

Locations

United States, Illinois

Global Medical Services

North Chicago, Illinois, United States, 60064

Sponsors and Collaborators

Abbott

Investigators

• Study Director: Cheryl Renz, MD; Abbott

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Jorgensen ME, Torp-Pedersen C, Finer N, Caterson I, James WP, Legler UF, Andersson C. Association between serum bilirubin and cardiovascular disease in an overweight high risk population from the SCOUT trial. Nutr Metab Cardiovasc Dis. 2014 Jun;24(6):656-62. doi: 10.1016/j.numecd.2013.12.009. Epub 2014 Jan 18.

Seimon RV, Espinoza D, Ivers L, Gebski V, Finer N, Legler UF, Sharma AM, James WP, Coutinho W, Caterson ID. Changes in body weight and blood pressure: paradoxical outcome events in overweight and obese subjects with cardiovascular disease. Int J Obes (Lond). 2014 Sep;38(9):1165-71. doi: 10.1038/ijo.2014.2. Epub 2014 Jan 10.

James WP, Caterson ID, Coutinho W, Finer N, Van Gaal LF, Maggioni AP, Torp-Pedersen C, Sharma AM, Shepherd GM, Rode RA, Renz CL; SCOUT Investigators. Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. N Engl J Med. 2010 Sep 2;363(10):905-17. doi: 10.1056/NEJMoa1003114.

Weeke P, Andersson C, Fosbol EL, Brendorp B, Kober L, Sharma AM, Finer N, James PT, Caterson ID, Rode RA, Torp-Pedersen C. The weight lowering effect of sibutramine and its impact on serum lipids in cardiovascular high risk patients with and without type 2 diabetes mellitus - an analysis from the SCOUT lead-in period. BMC Endocr Disord. 2010 Feb 26;10:3. doi: 10.1186/1472-6823-10-3.

Andersson C, Weeke P, Brendorp B, Kober L, Fosbol EL, Sharma AM, Finer N, Caterson ID, Rode RA, James PT, Torp-Pedersen C. Differential changes in serum uric acid concentrations in sibutramine promoted weight loss in diabetes: results from four weeks of the lead-in period of the SCOUT trial. Nutr Metab (Lond). 2009 Oct 14;6:42. doi: 10.1186/1743-7075-6-42.

• Responsible Party: Cheryl Renz, MD, Abbott
• ClinicalTrials.gov Identifier: NCT00234832
• Other Study ID Numbers: M01-392
• First Posted: October 10, 2005
• Results First Posted: April 15, 2010
• Last Update Posted: May 11, 2010
• Last Verified: May 2010

Keywords provided by Abbott:

Obesity; Sibutramine

Additional relevant MeSH terms:

Obesity; Overweight; Overnutrition; Nutrition Disorders; Body Weight; Sibutramine; Antidepressive Agents; Psychotropic Drugs; Appetite Depressants; Anti-Obesity Agents