Efficacy and Safety of Lorcaserin in Obesity: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Lorcaserin is a novel, selective 5-hydroxytryptamine 2C serotonin receptor agonist, approved for the treatment of obesity. Several phase 3 randomized controlled trials (RCTs) trials have shown a significant reduction in body weight with lorcaserin.We systematically searched the database of PubMed, Embase, The Cochrane Library and ClinicalTrials.gov up to July 31, 2019 and retrieved all the studies conducted with lorcaserin for ≥ 1-year that have explicitly reported the efficacy and safety outcomes versus placebo. Subsequently, we studied the effect of lorcaserin on weight reduction, FDA-defined valvulopathy, depression and suicidal risks in RCTs.The meta-analysis of four RCTs (N=16,856) demonstrated a significant decrease in body weight (mean ∆ -3. 076 Kg; 95% CI, -3.49 to -2.66; P <0.00001), compared to placebo. No significant difference in FDA-defined valvulopathy (RR 1.20; 95% CI, 0.89 to 1.63; P = 0.24), depression (RR 1.07; 95% CI, 0.80 to 1.43; P = 0.67) or suicidal risk (RR 1.43; 95% CI, 0.96 to 2.15; P = 0.08) has been observed with lorcaserin compared to placebo.Lorcaserin reduces body weight modestly, with no obvious serious adverse side effects. The common adverse events noted with lorcaserin include nausea, dizziness and transient headache.