Methods We undertook a phase II, randomised, double-blind, placebo-co n trolled trial in five Danish obesity management centres. After a 2 week run-in phase, 203 obese patients (body-mass index 30-<= 40 kg/m(2)) were prescribed an energy restricted diet and randomly assigned with a list of randomisation numbers to treatment with tesofensine 0 . 25 mg (n=52), 0.5 mg (n=50), or 1 . 0 mg (n=49), or placebo (n=52) once daily for 24 weeks. The primary outcome selleck compound was percentage change in bodyweight. Analysis was by modified

intention to treat (all randomised patients with measurement after at least one dose of study drug or placebo). The study is registered with ClinicalTrials.gov, number NCT00394667.

Findings 161 (79%) participants completed the study. After 24 weeks, the mean weight loss produced by diet and placebo was 2.0% (SE 0. 60). Tesofensine 0 . 25 mg, 0. 5 ing, and 1. 0 mg and diet induced a mean weight loss of 4.5% (0 . 87), 9.2% (0.91), and 10 . 6% (0-84), respectively, greater than diet and placebo (p<0. 0001). The most common adverse events caused by tesofensine were dry mouth, nausea, constipation, hard stools, diarrhoea, and insomnia. After 24 weeks, tesofensine 0 . 25 mg and 0 . 5 mg showed no significant increases in systolic or diastolic blood pressure compared with placebo, whereas heart rate was increased by 7.4 beats per min in the tesofensine 0. 5 mg group (p = 0. Cell Cycle inhibitor 0001).

Interpretation

Our results suggest that tesofensine 0 . 5 mg might have the potential to produce a weight loss twice that of currently approved drugs. However, these findings of efficacy and safety need confirmation in phase III trials.

Funding Neurosearch A/S, Denmark.”
“We created a comprehensive set of health-system performance measurements for China nationally and regionally, health-system coverage and catastrophic medical spending as major indicators. With respect to performance of health-care delivery, China has done well in provision of maternal and child health services, but poorly in addressing non-communicable diseases. For example, coverage of hospital delivery

increased from 20% in 1993 to 62% in 2003 for women living in rural areas. However, effective coverage FHPI in vivo of hypertension treatment was only 12% for patients living in urban areas and 7% for those in rural areas in 2004. With respect to performance of health-care financing, 14% of urban and 16% of rural households incurred catastrophic medical expenditure in 2003. Furthermore, 15% of urban and 22% of rural residents had affordability difficulties when accessing health care. Although health-system coverage improved for both urban and rural areas from 1993 to 2003, affordability difficulties had worsened in rural areas. Additionally, substanfial inter-regional and intra-regional inequalities in health-system coverage and healthcare affordability measures exist.