Obesity is a serious health
issue affecting an increasing number of people today. It increases the chances
of a person suffering from other conditions like hypertension and diabetes.
Weight reduction results in a decrease in these associated health issues.
Obesity is treated with
lifestyle modifications, medications as well as surgery. In the recent years, a
number of drugs previously used for obesity like sibutramine and rimonabant
have been banned due to side effects. Hence the search for an effective
anti-obesity drug or drug combination continues.
Researchers have recently
explored the use of a combination of two drugs, phentermine and topiramate, for
the treatment of obesity. Phentermine is an anti-obesity drug. Topiramate is a
drug normally used to treat epilepsy and to prevent migraines. The use of this combination for obesity was
earlier turned down by the FDA due to concerns of adverse effects like cognitive
disorders, metabolic acidosis, increased heart rate, and birth defects.
The CONQUER study was
carried out to assess the efficacy and safety of a combination of these two
drugs in the treatment of obesity. Two doses of the combination were studied in
overweight or obese individuals in the United States over a time period of 56
weeks. The individuals participating in the study also suffered from at least
two other weight- related health issues like high blood pressure, high
cholesterol, prediabetes, diabetes and abdominal obesity.
The researchers found that the combination of phentermine and
topiramate in both lower as well as higher doses produced significant weight
loss. Weight reduction also resulted in an improvement of the associated
illnesses like diabetes, high cholesterol and hypertension. The combination
produced side effects like dry mouth, constipation, paresthesias, altered
taste, and some psychiatric and cognitive effects.
These side effects are
known side effects of the drugs when used separately, and no untoward side
effects were noted with the combination. People with depression were not used
in the study. Birth defects were not mentioned in the study.
Thus, according to the
CONQUER study, the combination of phentermine and topiramate is an effective
treatment in obesity with manageable and tolerable side effects. It also helps
in reduction of other associated illnesses with obesity. The combination is yet
to be approved by the FDA for the treatment of obesity.
Source: Effects of low-dose, controlled-release, phentermine plus
topiramate combination on weight and associated comorbidities in overweight and
obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. The
Lancet 2011; 377 (9774): 1341 - 1352.