Zhaoping Li, MD, PhD; Margaret Maglione, MPP; Wenli Tu, MS; Walter Mojica, MD; David Arterburn, MD, MPH; Lisa R. Shugarman, PhD; Lara Hilton, BA; Marika Suttorp, MS; Vanessa Solomon, MA; Paul G. Shekelle, MD, PhD; Sally C. Morton, PhD
Disclaimer: The authors of this article are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services of a particular drug, device, test, treatment, or other clinical service.
Acknowledgments: The authors thank Alison Avenell for allowing us access to the National Health Service Health Technology Assessment report.
Grant Support: This article was supported by a contract to the Southern California Evidence-based Practice Center from the Agency for Healthcare Quality and Research.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Zhaoping Li, MD, PhD, West LA Veterans Affairs Medical Center, W111A, 11301 Wilshire Boulevard, Los Angeles, CA 90073.
Current Author Addresses: Drs. Li and Shekelle: West LA Veterans Affairs Medical Center, W111A, 11301 Wilshire Boulevard, Los Angeles, CA 90073.
Dr. Maglione, Mr. Tu, Dr. Mojica, Dr. Shugarman, Ms. Hilton, Ms. Suttorp, and Dr. Morton: RAND, 1776 Main Street, Santa Monica, CA 90407.
Dr. Arterburn: Cincinatti Veterans Affairs Medical Center, 3200 Vine Street, Cincinatti, OH 45220.
Ms. Solomon: Charles Drew University, 1748 East 118th Street, Building N, Los Angeles, CA 90059.
Li Z, Maglione M, Tu W, Mojica W, Arterburn D, Shugarman LR, et al. Meta-Analysis: Pharmacologic Treatment of Obesity. Ann Intern Med. 2005;142:532-546. doi: 10.7326/0003-4819-142-7-200504050-00012
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Published: Ann Intern Med. 2005;142(7):532-546.
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Kishore M Gadde
May 2, 2005
Meta-analysis of pharmacologic treatment of obesity utilised irrelevant data
For assessing weight loss efficacy of bupropion in the treatment of obesity, Li et al have pooled data from 3 RCTs.
It is rather amusing that the largest data for bupropion's weight loss efficacy in this meta-analysis came from a trial (Croft et al 2002) assessing antidepressant efficacy of bupropion in patients with major depression. The primary outcome in that trial was not weight loss. The primary diagnosis of these patients was not obesity. Most of the patients in the study were not even obese. These patients did not enter this trial with the intent of losing weight. Bupropion was not tested in this trial for its weight loss.
Li et al have erred in including data from this DEPRESSION study in a meta-analysis of pharmacologic treatment of OBESITY. These investigators have failed to see the difference between INTENTIONAL weight loss as the desired effect and a SIDE EFFECT reported in a sample that is not the topic of this meta-analysis.
Received research funding from GSK, Lilly, Elan and Forest Labs.
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