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Contrave Heart Benefits Are Unproven, FDA Restrictions Should be Added to Obesity Drug: Editorial

  • Written by: Irvin Jackson
  • 3 Comments

Some health experts are calling for federal drug regulators to place restrictions on the obesity drug Contrave, due to the actions of officials and researchers working on a clinical trial, who overstated the drug’s benefits before they could be proven. 

In an editorial published in the Journal of the American Medical Association (JAMA), former FDA deputy director Joshua Sharfstein and researcher Bruce Psaty call for the FDA to restrict use of Orexigen’s relatively new drug, after the company prematurely claimed Contrave has heart benefits, even though only 25% of the clinical trial was completed.

The release of information revealed that Orexigen officials had been improperly given access to the trial data and the clinical trial was halted. However, the FDA had already approved the drug for market based on interim results. The incomplete results were published in the same issue of JAMA on March 8.

Researchers note in the published data that the heart safety of Contrave remains uncertain, and also found that 14.2% of users suffered gastrointestinal events that may have been caused by side effects of Contrave, compared with 1.9% among those taking a placebo. The findings also suggest that 5.1% of users developed central nervous system problems, compared to 1.2% who were given a placebo.

Contrave (naltrexone-bupropion) is a combination of drug abuse and smoking cessation drugs like Vivitrol and Zyban, and was developed and distributed by Orexigen in partnership with Takeda Pharmaceuticals. It was approved by the FDA in 2014, and already carries a black box warning for the risk of suicidal behavior and other neuropsychatric events known to plague bupropion.

Drs. Sharfstein and Psaty recommend that the FDA use its regulatory muscle to restrict Contrave, possibly through a Risk Evaluation and Mitigation Strategy (REM), to punish the company for releasing incomplete and misleading data, and to warn consumers and the medical community that the actual benefits of Contrave are unknown and it is unclear if the benefits outweigh the risks, which can include gastrointestinal illness and central nervous system problems, according to the partial study results.

The pair also raised questions about the FDA’s process of approving drugs with only interim cardiovascular trial data, pointing to the Contrave case. However, the FDA has argued that cardiovascular trial data can take years to develop, and that it would create long delays if drug manufacturers had to wait until they were completed to place a drug on the market.

The revelation of the partial trial data occurred when Orexigen CEO Mike Narachi filed for a patent for Contrave, using the partial data. The patent process made the data go public and gave the appearance that the drug had cardiovascular benefits which had never before been seen. Critics say Narachi should have never had access to the data, and the Cleveland Clinic, which had been employed to conduct the clinical trial, halted the research and canceled its deal with the company in protest.

A new clinical trial is being conducted, but the results may be years away. In the meantime, doctors have already written more than 765,000 Contrave prescriptions.

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3 comments

  1. Angela Reply

    I was prescribed Contrave in Feb of 2015 I was on it for a year and a half and still have a open script.On March 3, 2018 I was diagnosed with stage 4 liver cancer. I am 57 years old never smoked and ,don’t drink. I had my gallbladder removed late 2016 and there was no signs of any cancer then. The cancer appeared suddenly and fast starting in the liver. I’ve had a CT, ultrasound, Bonescan, MRI, xrays, Pet scan and tons of blood work. After seeing a new commercial for Contrave with the Liver warnings I put it all together. The script says to be given to people with a BMI of no less than 30 %. However mine has never been close to that nor did the. Writhing physician ever test me first.
    I have medical records as to the status of my current medical condition and past. Please contact me as they’ve given me 1 year to live if I choose No Chemo. The Chemo they want to start me on would kill my Nervous system,Hearing, and Kidneys. The mass in my liver is 8 cm(4”’) and. Is inoperable . Over 765,000 scripts have been written on this med. And over 9,000 people in one lawsuits.
    This medication was prematurely approved by the FDA and needs to be pulled from the market.
    If you can help me I would be forever grateful if I don’t here back I’ll keep trying till the day I die.

  2. Bonnie Reply

    I took only one pill and it took a way all my pain meds in my pump, I ended up crashing my car,

  3. Tan Reply

    I have debilitating gastroenteritis and the formation of blood clots since taking Contrave. The drug was released prematurely without enough studies being conducted before releasing to the public.

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