Once-Daily Lorcaserin Approved. Now What?

Eisai and Arena Pharmaceuticals announced this week that they received final approval from FDA for once-daily lorcaserin, which will be sold as Belviq XR for long-term obesity treatment.

The real question is: what will this mean for the product, the patients who can benefit from it, and for obesity care more broadly?

This approval will certainly be an improvement over the twice-daily regiment that is currently marketed. In genral, people have a tough time remembering to take a medicine more than once a day.

A recent study examined the patient records for people taking meds to treat venous blood clots. The results showed that people were 40 to 60 percent better at taking all their doses with a once-daily. Considering that those medications treat a potentially life-threatening condition, this difference is pretty striking.

Giving people a simpler regimen makes a big difference in having them stick with taking their medicine. So for the people who might benefit from Belviq, a once-daily form is a definite plus.

But the bigger picture for Belviq and for folks who invested in its development is a bit more challenging. The market for new obesity medicines continues to be small and slow to grow. Right now the only new product that’s growing is Saxenda, a form of liraglutide which is also used to treat diabetes at a lower dose.

While Belviq XR will certainly be an improvement, we don’t expect that it will reverse the current trend of sliding sales for the brand. At best, it might help stop the losses.

The other major hope for reviving Belviq lies with a large cardiovascular outcomes trial, currently ongoing. When results are available in 2018, a significant effect on survival would certainly be a breakthrough result. Only bariatric surgery has proven to help people with obesity live longer.

But that news will not come until 2018. For now, Belviq will continue to be a specialty drug that benefits a few patients who respond especially well to it. And it will be easier to take in a once-daily form.

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Daily Faust, photograph © carnagenyc / flickr

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July 21, 2016