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Efficacy and Safety of Phentermine/Topiramate in Adults with Overweight or Obesity: A Systematic Review and Meta-Analysis.
- Source :
-
Obesity (Silver Spring, Md.) [Obesity (Silver Spring)] 2021 Jun; Vol. 29 (6), pp. 985-994. Date of Electronic Publication: 2021 Apr 16. - Publication Year :
- 2021
-
Abstract
- Objective: 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.<br />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 risk-of-bias tool. Meta-analysis was performed using random-effect models.<br />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: 2.22-4.88) for 3.75/23 mg, 7.27 kg (95% CI: 6.40-8.13) for 7.5/46 mg, and 8.25 kg (95% CI: 6.92-9.79) for 15/92 mg. For phentermine/topiramate participants in different weight-loss subgroups, the weight loss of participants with ≥5%, ≥10%, and ≥15% baseline weight loss was 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. Compared with placebo, the adverse events associated with the treatment mainly included dysgeusia (odds ratio [OR] = 8.86, 95% CI: 5.65-13.89), paresthesia (OR = 8.51, 95% CI: 6.20-11.67), dry mouth (OR = 6.71, 95% CI: 5.03-8.94), disturbance in attention (OR = 4.48, 95% CI: 2.39-8.41), irritability (OR = 4.10, 95% CI: 2.29-7.33), hypoesthesia (OR = 3.81, 95% CI: 1.32-11.00), constipation (OR = 2.43, 95% CI: 2.02-2.93), and dizziness (OR = 2.26, 95% CI: 1.72-2.98). Phentermine/topiramate also reduced waist circumference, blood pressure, blood sugar levels, and lipid levels.<br />Conclusions: Phentermine/topiramate has considerable benefit in reducing body weight, and the efficacy was closely related to the dosage. However, it increased the risk of nervous system-related adverse events.<br /> (© 2021 The Obesity Society.)
- Subjects :
- Adult
Blood Pressure drug effects
Body Weight drug effects
Drug Therapy, Combination
Female
Fructose administration & dosage
Humans
Male
Middle Aged
Obesity epidemiology
Obesity physiopathology
Overweight epidemiology
Overweight physiopathology
Randomized Controlled Trials as Topic statistics & numerical data
Treatment Outcome
Weight Loss drug effects
Obesity drug therapy
Overweight drug therapy
Phentermine administration & dosage
Phentermine adverse effects
Topiramate administration & dosage
Topiramate adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1930-739X
- Volume :
- 29
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Obesity (Silver Spring, Md.)
- Publication Type :
- Academic Journal
- Accession number :
- 33864346
- Full Text :
- https://doi.org/10.1002/oby.23152