Evaluation of phentermine and topiramate versus phentermine/topiramate extended‐release in obese adults

Abstract

Objective: A 28-week, randomized, controlled trial compared the combination of phentermine and topiramate extended-release (PHEN/TPM ER) with its components as monotherapies and with placebo in obese adults. Design and Methods: Subjects were randomized to placebo, phentermine 7.

Anti-Obesity Therapy: from Rainbow Pills to Polyagonists

“…The exact mechanism(s) of how topiramate improves systemic metabolism remains a subject of ongoing investigations. In any case, when given as an adjunct to phentermine, weight loss of this combination is greater as treatment with phentermine or topiramate alone (Aronne et al, 2013). In line with this notion, placebo-subtracted weight loss induced by the phentermine-topiramate combination is typically in the range of 5.9%-9.6% (Garvey et al, 2012(Garvey et al, , 2014aWinslow et al, 2012;Aronne et al, 2013), and is associated with an improvement in glucose management (Garvey et al, 2012(Garvey et al, , 2014a and the cardiovascular risk profile (Garvey et al, 2012(Garvey et al, , 2014b.…”

“…The use of topiramate for these clinical applications seems to reside in its ability to selectively decrease CNS neuronal activity via inhibition of certain neuronal Ca 2+ channels (Martella et al, 2008) as well as to modulate central glutamate and GABA signaling (White et al, 2000;Edvinsson and Linde, 2010). When used as monotherapy, placebo-subtracted weight loss induced by topiramate typically ranges between 3.8% and 6.5% depending on the dose (Aronne et al, 2013). The exact mechanism(s) of how topiramate improves systemic metabolism remains a subject of ongoing investigations.…”

Updates on obesity pharmacotherapy

“…This was significantly less absolute weight loss than what was produced from combination therapy of phentermine/topiramate ER 7.5/46 mg and phentermine/topiramate ER 15/92 mg groups (8.3 versus 9.0 kg). 29 In summary, phentermine is a very affordable medication that has been on the market for over a half-century with widespread use in the United States. It leads to clinically significant weight loss of typically 3-5% in 12 weeks.…”

Obesity: A Review of Pathogenesis and Management Strategies in Adult

“…If a patient does not reach this target, the drug should be discontinued. [70][71][72][73] The efficacy and safety of the drug were assessed in the following RCTs: EQUIP 84 , CONQUER 67 , SEQUEL 85 and EQUATE 86 . Adverse events associated with treatment were dry mouth, constipation, insomnia, palpitations, dizziness, paraesthesia, disturbances in attention, metabolic acidosis and renal calculi, headache, dysgeusia (distortion of sense of taste), alopecia and hypokalaemia.…”