Can an early weight management program (WMP) prevent olanzapine (OLZ)-induced disturbances in body weight, blood glucose and lipid metabolism? Twenty-four- and 48-week results from a 6-month randomized trial

Abstract

Objectives. This study was designed to investigate whether a preventive weight management program (WMP) reduces weight gain during olanzapine (OLZ) treatment. Moreover, we examined the effects of intervention on metabolic parameters. Methods. Patients (N = 100) with schizophrenia or schizoaffective disorder (DSM-IV) who had commenced treatment with OLZ were recruited. Following a run-in period of 4 weeks, 74 patients who had gained at least 1.5 kg body weight were randomized to receive either 12 bi-weekly WMP sessions (prevention group (PG), n = 36), or usual care (control group (CG), n = 38). Anthropometric and metabolic parameters were assessed after the 24-week intervention phase and a 24-week follow-up. Results. Forty-two percent of 74 participants (PG: 36.1%, CG: 47.4%) finished the 24-week intervention phase while 34% of them (PG: 30.6%, CG: 36.8%) completed the 48-week study. There was no significant difference in weight gain between groups (PG: + 3.4 ± 4.2 kg vs. CG: + 4.5 ± 6.1 kg, P = 0.184) after 24 weeks. Nevertheless, PG showed a significantly smaller increase in waist circumference than CG (PG: + 4.6 ± 8.3 cm, CG: + 10.1 ± 7.3 cm, P = 0.019) after 48 weeks. Furthermore, PG showed a significantly smaller increase in fasting glucose (P = 0.031) and 2-h glucose after oral glucose load (P = 0.018) than CG. Conclusions. These results suggest that preventive WMP may reduce the risk of abdominal obesity and deterioration of glucose metabolism in OLZ-treated patients.

Key words::

• Schizophrenia
• diabetes mellitus
• olanzapine
• prevention
• weight management

Acknowledgments

The authors thank the study nurses Bettina Schuler and Horst Franken-Rugies for managing the study, and the dietician Cornelia Humpf for conducting the weight management program. Financial support by Lilly Deutschland GmbH, Bad Homburg, Germany (F1D-SB-0189). The funding source had no influence on study design, data collection, analysis, and interpretation of data, writing and submission of the manuscript.

Statement of Interest

Joachim Cordes, MD: Research support: Lilly Deutschland GmbH, Pfizer GmbH, Janssen-Cilag GmbH; Speakers: Servier, Tanita Europe, Alpine Biomed; Congress support: Astra Zeneca, Janssen-Cilag GmbH. Christoph Correll, MD: Consultant: Astra Zeneca, Bristol-Myers Squibb, Eli Lilly, Hoffmann–La Roche, Intra-Cellular Therapies, Medicure, Pfizer, Otsuka, Vanda. Honoraria: Boeringer Ingelheim, GSK, Lundbeck, OrthoMcNeill-Janssen. Speakers or advisory boards: Actelion, AstraZeneca, Bristol Myers Squibb, Intra-Cellular Therapies, Merk, Otsuka, Pfizer, Schering-Plough, Sepracor/Sunovion, Takeda. Wolfgang Gaebel has received symposia support, speakers honoraria and research grants from the following companies: AstraZeneca GmbH, Wedel; Janssen-Cilag GmbH, Neuss; Lilly Deutschland, Bad Homburg; Lundbeck Institute, Denmark. He is a member of the Scientific Advisory Board of: Janssen Cilag GmbH, Neuss; Lilly Deutschland GmbH, Bad Homburg; Lundbeck International Neuroscience Foundation, Denmark. Kai Kahl, MD: Honoraria: Bristol-Myers Squibb GmbH, Servier, Eli Lilly Deutschland, Lundbeck. Christian Lange-Asschenfeldt, MD: Speakers: Novartis, Pfizer, Otsuka. Hans Hauner received speakers honoraria from Lilly, Novartis, Bristol Myers Squibb, Novo Nordisk, Sanofi-Aventis and Roche and is a member of the International Advisory Board of Weight Watchers.