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In Reply: Drs Dora and Scheffel express the opinion that the STRADIVARIUS trial should have compared weight loss achieved with rimonabant with that achieved using another antiobesity drug rather than placebo. They state that other therapies have already shown proven benefits for the condition we studied. We disagree.

Although antiobesity therapies currently exist, they have been shown only to produce weight loss and certain related metabolic benefits. No antiobesity treatment has demonstrated the ability to reduce the progression of coronary atherosclerosis. The scientific question under consideration was not whether rimonabant was better or worse than other antiobesity drugs at inducing weight loss but whether this therapy could slow atherosclerosis progression in abdominally obese patients with preexisting coronary artery disease. We believe that this is an important scientific question that has significant implications for effective use of current and future weight loss strategies in patients with heart disease.

When we designed . . . [Full Text of this Article]

Steven E. Nissen, MD
nissens@ccf.org

Stephen J. Nicholls, MD, PhD; Kathy Wolski, MPH
Department of Cardiovascular Medicine
Cleveland Clinic
Cleveland, Ohio

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RELATED ARTICLE

Effect of Rimonabant on Progression of Atherosclerosis in Patients With Abdominal Obesity and Coronary Artery Disease: The STRADIVARIUS Randomized Controlled Trial
Steven E. Nissen, Stephen J. Nicholls, Kathy Wolski, Josep Rodés-Cabau, Christopher P. Cannon, John E. Deanfield, Jean-Pierre Després, John J. P. Kastelein, Steven R. Steinhubl, Samir Kapadia, Muhammad Yasin, Witold Ruzyllo, Christophe Gaudin, Bernard Job, Bo Hu, Deepak L. Bhatt, A. Michael Lincoff, E. Murat Tuzcu, and for the STRADIVARIUS Investigators
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RELATED LETTER

Rimonabant and Progression of Atherosclerosis in Obese Persons
José Miguel Dora and Rafael Selbach Scheffel
JAMA. 2008;300(3):280.
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