Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta‐Analysis

Abstract

The study objective was to examine the association between phentermine/topiramate therapy and weight loss and adverse events in adults with overweight or obesity by meta-analysis and systematic review. Methods: Medical Subject Headings and free-text terms were selected to search for eligible trials in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase up to April 18, 2020. The quality of randomized controlled trials was evaluated by the Cochrane riskof-bias tool. Meta-analysis was performed using random-effect models. Results: Phentermine/topiramate therapy resulted in an average weight loss of 7.73 kg (95% CI: 6.60-8.85) in general compared with placebo. The weight loss was related to the dose of phentermine/topiramate. Compared with placebo, the average weight loss was 3.55 kg (95% CI:

FDA-Approved Pharmacotherapy for Weight Loss Over the Last Decade

“…Shibuya et al reported average weight loss with any pharmacotherapy to be 3.45% of body weight from baseline; however, participants taking naltrexone-bupropion lost 2.66 ± 5.03% of body weight compared to 3.63 ± 5.7% with phentermine-topiramate (P < 0.0001) [23]. Lei et al found phentermine-topiramate effective in the reduction of body weight as well as waist circumference, blood pressure, lipid levels, and plasma glucose levels [24]. The dosage affected the efficacy, and a limiting factor was the association of phentermine-topiramate with nervous system side effects [24].…”

The different effects of psyllium husk and orlistat on weight control, the amelioration of hypercholesterolemia and non-alcohol fatty liver disease in obese mice induced by a high-fat diet

“…Examples include phentermine, an appetite suppressant, and topiramate, an antiepileptic, which have both been approved to treat obesity by the US Food and Drug Administration (FDA); 5,6 however, they can have significant neurorelated side effects. 7 Phenylpropanolamine, a metabolic stimulant, is used to treat obesity in the US; however, it is shown to increase the risk of haemorrhagic stroke. 8 Orlistat, a nutrition absorption inhibitor, is available worldwide as an obesity treatment.…”

The Obese Brain: Mechanisms of Systemic and Local Inflammation, and Interventions to Reverse the Cognitive Deficit

“…Most weight control medications act in the brain to stimulate satiety signals, motivationally helping the patients adhere to their dietary interventions, with the primary goal of weight loss. Medical guidelines recommend seven drug treatments for weight control, including orlistat, liraglutide, phentermine, phentermine/topiramate, lorcaserin, and naltrexone/bupropion ( Lei et al, 2021 ).…”

“…Another beneficial effect of phentermine/topiramate treatment was the waist-circumference reduction, blood pressure, blood sugar levels, and lipid levels decrease. However, this drug combination risks adverse events related to the nervous system ( Lei et al, 2021 ).…”