This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Medical Practice  • Medical Ethics  • Obesity  • Cardiovascular System  • Statistics and Research Methods  • Cardiovascular Disease/ Myocardial Infarction  • Drug Therapy  • Drug Therapy, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

The primary end point used was percent atheroma volume (PAV), determined using intravascular ultrasound. Decrease in body weight is associated with favorable changes in the metabolic profile, which may reduce progression of atherosclerotic disease. The strategy of using a primary end point of PAV rather than weight reduction in this study seems to . . . [Full Text of this Article]

José Miguel Dora, MD
jmdora@gmail.com

Rafael Selbach Scheffel, MD
Endocrine Division
Hospital de Clínicas de Porto Alegre
Porto Alegre, Brazil

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?