Orlistat, a lipase inhibitor, may lower uric acid levels in patients with obesity, according to new research.

Investigators led by Khadijeh Mirzaei, PhD, of Tehran University of Medical Sciences in Tehran, Iran, conducted a meta-analysis of 7 trials (9 datasets) including 1786 adults with overweight or obesity. Orlistat (tetrahydrolipstatin) was administered at 120 mg thrice daily or 360 mg/dL.

Over 3 to 6 months, serum uric acid significantly declined by 17.7 µmol in the orlistat group compared with the placebo or control group, the investigators reported in the International Journal of Clinical Practice. In descending order, results were robust in patients with metabolic syndrome, hypercholesterolemia, polycystic ovary syndrome, and nonalcoholic fatty liver disease.

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With regard to possible mechanisms, the investigators suggested orlistat may lower serum uric acid levels via weight loss. In some studies included in the meta-analysis, patients were also asked to adopt a low-calorie, fat-restricted diet and to exercise.

Orlistat has demonstrated other beneficial effects. In another recent study, published in European Heart Journal – Cardiovascular Pharmacotherapy, orlistat use was significantly associated with a 22%, 23%, 32%, 21%, and 61% lower risk for stage 3 or higher chronic kidney disease, myocardial infarction, ischemic stroke, new-onset heart failure, and death, respectively, compared with no treatment.


Noori S, Mirzababaei A, Amini MR, Mirzaei K. Effect of orlistat on serum uric acid level in adults: a systematic review and meta-analysis of randomized controlled trials. Int J Clin Pract. Published online July 29, 2021. doi:10.1111/ijcp.14674

Ardissino M, Vincent M, Hines O, et al; on behalf of the Imperial Obesity Study Group. Long-term cardiovascular outcomes after orlistat therapy in patients with obesity: a nationwide, propensity-score matched cohort studyEur Heart J Cardiovasc Pharmacother. Published online May 15, 2021. doi:10.1093/ehjcvp/pvaa133