New obesity treatment rejected by NICE

The obesity treatment naltrexone/bupropion (Mysimba) should not be routinely prescribed on the NHS, NICE has decided.

Current management for overweight and obesity is lifestyle measures alone, lifestyle measures with orlistat or bariatric surgery. | FredFroese/iStock
Current management for overweight and obesity is lifestyle measures alone, lifestyle measures with orlistat or bariatric surgery. | FredFroese/iStock

Naltrexone/bupropion is not recommended within its marketing authorisation for managing overweight and obesity in adults alongside a reduced-calorie diet and increased physical activity.

NICE acknowledged clinical trial evidence showing that naltrexone/bupropion in combination with lifestyle measures is more effective than lifestyle measures alone, but noted that the combination's long-term effectiveness is unknown.

The appraisal committee felt that the cost effectiveness of naltrexone/bupropion could not be definitively calculated because of uncertainties in the modelling assumptions. Given that large numbers of people could be eligible for long-term treatment, the committee concluded that more certainty is needed that naltrexone/bupropion will provide value for the NHS.

Mysimba is indicated as an adjunct to a reduced-calorie diet and increased physical activity for the management of weight in adults with an initial BMI of ≥30kg/m2 (obese), or ≥27kg/m2 to <30kg/m(overweight) in the presence of one or more weight-related co-morbidities, such as type II diabetes, dyslipidaemia, or controlled hypertension.

Naltrexone is a μ-opioid antagonist and bupropion a weak inhibitor of neuronal dopamine and noradrenaline reuptake. The two drugs are thought to have complementary actions on CNS pathways regulating body weight. 

Want news like this straight to your inbox?
Sign up for our bulletins

Chloe Harman recommends

Sign up for MIMS bulletins

Read more

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register
Already registered?
Sign in

More from MIMS

New once-weekly GLP-1 agonist for diabetes

New once-weekly GLP-1 agonist for diabetes

Ozempic (semaglutide) is a glucagon-like peptide-1...

Gluten-free prescribing restricted to bread and mixes

Gluten-free prescribing restricted to bread and mixes

GPs in England are no longer able to prescribe gluten-free...

New vitamin D deficiency thresholds recommended

New vitamin D deficiency thresholds recommended

The National Osteoporosis Society (NOS) has updated...

SGLT2 inhibitors associated with increased risk of lower-limb amputation in new study

SGLT2 inhibitors associated with increased risk of lower-limb amputation in new study

SGLT2 inhibitors may be linked to a doubling in the...