Xenical - is "oily spotting" a treatment effect or a side effect?

From Australia, Ray Moynihan writes:

The controversial anti-fat drug Xenical has been given a new lease of life, with the announcement of a special financial arrangement between pharmacists and Swiss drug giant Roche.

The commercial arm of the Pharmacy Guild has just signed a deal with Roche to become the "brand manager" for Xenical, a drug criticised for modest benefits and the side effects of oily diarrhoea.

The Guild represents almost 5000 Australian pharmacists, and its commercial arm Gold Cross already endorses many products, including vitamins, cold and flu tablets and methadone.

But this latest deal to "brand manage" Xenical has attracted fierce criticism from Adelaide GP Dr Peter Mansfield, who says the drug is "almost ineffective and has frequent unpleasant adverse effects." A recent review of trials showed that over a year, in combination with a special diet, the drug may help someone lose 3 kg more than a person who simply had the diet. Up to a third of those taking the drug suffer problems including "oily stool, faecal urgency and oily spotting."

Attacking the deal Mansfield told Crikey: "Pharmacists need to decide if they want to work for the drug companies or for their patients. This is a short term temptation to make money at the expense of public trust in the long run."

Roche has already come under heavy flak for Xenical TV ads run during Australian Idol, attracting criticism it was marketing the drug to healthy young people concerned about body image.

The Pharmacy Guild’s national president Kos Sclavos strongly defended the deal and rejected criticisms of Xenical.

"It is one of the few proven efficacious drugs for weight loss" he said.

"We disagree with assertions that the product has a significant side effect profile. The diarrhea, the side effect, is actually part of the way the product works."

According to Sclavos, the Guild’s commercial arm stepped in because Roche had essentially stopped marketing it, and there was fear the company would withdraw it. He also criticized the Roche TV ads and said the drug would be marketed "professionally."

Crikey