To the Editor: In the STRADIVARIUS trial, Dr Nissen and colleagues1 studied the effect of rimonabant on progression of atherosclerosis in patients with abdominal obesity and coronary artery disease. We would like to raise a number of issues about this trial.
From an ethical perspective, new treatments should be tested when possible against an established treatment with proven benefits, rather than against placebo. Medications other than rimonabant have been shown to be superior to placebo for weight reduction in obese patients,2,3 but in the STRADIVARIUS trial the interventions studied were either rimonabant (20 mg daily) or placebo.
Dora JM, Scheffel RS. Rimonabant and Progression of Atherosclerosis in Obese Persons. JAMA. 2008;300(3):280-281. doi:10.1001/jama.2008.24