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Treatment with rimonabant, a selective cannabinoid receptor type 1 antagonist, is associated with reduced food intake, weight loss, and improved cardiometabolic risk factors. In the multicenter Strategy to Reduce Atherosclerosis Development Involving Administration of Rimonabant—the Intravascular Ultrasound Study (STRADIVARIUS), patients with abdominal obesity, the metabolic syndrome, and preexisting coronary artery disease were randomly assigned to rimonabant or placebo and underwent coronary intravascular ultrasonography at baseline and after 18 months of treatment. Nissen and colleagues found that compared with placebo, rimonabant had no significant effect on the study's primary efficacy outcome—change in percent atheroma volume. In an editorial, Rumsfeld and Nallamothu discuss the importance of assessing clinical rather than surrogate outcomes in investigations of new therapies and discuss the safety of rimonabant.
This Week in JAMA . JAMA. 2008;299(13):1509. doi:10.1001/jama.299.13.1509
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