Efficacy and safety of phentermine/topiramate in adults with overweight or obesity: A meta-analysis and systematic review

Abstract

Objective: To examine the association between phentermine/topiramate therapy and weight loss and adverse events in adults with overweight problems or obesity by meta-analysis and systematic review. Methods: Medical Subject Headings (MeSH) and free-text terms related to phentermine/topiramate 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 Cochrane risk-of-bias tool. Meta-analysis was performed using random-effect models. Our systematic review protocol, registered on PROSPERO (registration number CRD42020188324). Results: Phentermine/topiramate therapy resulted in a weight loss of 7.73 kg (95% confidence interval [CI]: 6.60, 8.85) compared to placebo. For phentermine/topiramate subjects in different weight loss subgroups, the weight loss of subjects with ≥5%, ≥10%, and ≥15% baseline weight loss were 3.18 (95% CI: 2.75, 3.67), 5.32 (95% CI: 4.53, 6.25), and 5.65 (95% CI: 3.55, 9.01), respectively. Phentermine/topiramate reduced waist circumference, blood pressure, blood sugar levels, and lipid levels. The adverse effects associated with the treatment mainly included Dysgeusia, Paresthesia, Dry mouth. Conclusions: Phentermine/topiramate reduced body weight and was well tolerated. However, it increased the risk of nervous system-related adverse events to a certain extent, but the symptoms are not serious. Long-term clinical and pharmacological studies are needed to understand the long-term efficacy and safety of phentermine/topiramate.

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 Foods and Drug Administration (FDA); 5,6 however, they can have significant neurorelated side effects. 7 Phenylpropanolamine, a metabolic stimulant, has been used to treat obesity in the US; however, it has been shown to increase the risk of haemorrhagic stroke. 8 Orlistat, a nutrition absorption inhibitor, is available worldwide as an obesity treatment.…”

Efeitos e segurança do uso off label do topiramato na perda de peso

“…Duas pesquisas avaliaram a combinação do Topiramato com a metformina. Outras cinco avaliaram a combinação do Topiramato com a fentermina [14][15][16][17][18][19][20] ; Efeitos e segurança do uso off label do topiramato na perda de peso conforme mostrou a maioria das pesquisas analisadas, pois apenas em uma das pesquisas foi possível identificar, que a terapia combinada de Topiramato e fentermina não foi bem tolerada, em que mais da metade dos pacientes parou de tomá-lo devido aos efeitos adversos 16 .…”

“…Em uma meta-análise de ensaios clínicos randomizados a terapia com fentermina combinada com o Topiramato resultou em uma perda de peso de 7,73 kg, reduziu a circunferência da cintura, a pressão arterial, os níveis de açú-car no sangue e os níveis de lipídios. Os efeitos adversos associados ao tratamento incluíram principalmente disgeusia, parestesia, boca seca 19 .…”

Pharmacological Management of Obesity: A Century of Expert Opinions in Cecil Textbook of Medicine

“…103 A recent misanalysis indicated that the highest dose of this combination, that is, 15 mg of phentermine and 92 mg of topiramate produced an average weight loss of 8.25 kg. 104 Common side effects included dysgeusia, dry mouth, constipation, paresthesias, dizziness, and insomnia. 103,104…”

“…104 Common side effects included dysgeusia, dry mouth, constipation, paresthesias, dizziness, and insomnia. 103,104…”