Abstract
Introduction: obesity is a chronic disease that can manifest itself at any stage of life, with an increasing incidence and prevalence, which contributes to other health problems.
Objective: to determine the application of Phentermine and Topiramate in the treatment of obesity.
Methods: a search for clinical trials and randomized controlled trials was conducted. The search was carried out exhaustively in the search engines/databases PubMed, Cachrane Library, Scopus, Google Scholar and Web of Science.
Results: 21 studies were identified, of which 11 met the inclusion criteria. The evaluated research articles provided moderate evidence that the combination of Phentermine and Topiramate is effective and safe for the treatment of obesity. A gradual decrease in patients' body weight was observed from the start of treatment and up to 20 weeks thereafter. In addition, notable secondary outcomes, such as changes in blood pressure, triglyceride levels, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol and glycosylated hemoglobin (A1C) were found from the start of treatment.
Conclusion: the doses of these drugs for chronic weight control in adults are 3,75 mg, 7,5 mg and 15 mg in the case of phentermine and 23 mg, 46 mg and 92 mg of topiramate, being the maximum recommended dose 15 mg/92 mg. If a 5 % weight loss is not achieved after 12 weeks with this dose, their use should be reconsidered
References
Tahrani AA, Morton J. Benefits of weight loss of 10% or more in patients with overweight or obesity: A review. Obesity. abril de 2022;30(4):802-40.
Tak YJ, Lee SY. Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand? Curr Obes Rep. marzo de 2021;10(1):14-30.
Song JE, Ko HJ, Kim AS. Comparison of the Efficacy of Anti-Obesity Medications in Real-World Practice. Drug Des Devel Ther. marzo de 2024;Volume 18:845-58.
Calderon G, Gonzalez-Izundegui D, Shan KL, Garcia-Valencia OA, Cifuentes L, Campos A, et al. Effectiveness of anti-obesity medications approved for long-term use in a multidisciplinary weight management program: a multi-center clinical experience. Int J Obes. marzo de 2022;46(3):555-63.
Ritchey ME, Harding A, Hunter S, Peterson C, Sager PT, Kowey PR, et al. Cardiovascular Safety During and After Use of Phentermine and Topiramate. J Clin Endocrinol Metab. 1 de febrero de 2019;104(2):513-22.
Mital S, Nguyen HV. Cost-Effectiveness of Antiobesity Drugs for Adolescents With Severe Obesity. JAMA Netw Open. 12 de octubre de 2023;6(10):e2336400.
Houssarini JA, Franklin J, Markovic T, Hocking SL. Duration of therapy of cost-subsidised phentermine and topiramate in patients with obesity: A retrospective medical records audit of an Australian single site. Obes Res Clin Pract. enero de 2024;18(1):73-5.
Fox CK, Vock DM, Sherwood NE, Gross AC, Ryder JR, Bensignor MO, et al. SMART use of medications for the treatment of adolescent severe obesity: A sequential multiple assignment randomized trial protocol. Contemp Clin Trials. marzo de 2024;138:107444.
Kim A, Nguyen J, Babaei M, Kim A, Geller DH, Vidmar AP. A Narrative Review: Phentermine and Topiramate for the Treatment of Pediatric Obesity. Adolesc Health Med Ther. agosto de 2023;Volume 14:125- 40.
Grabarczyk TR. Observational Comparative Effectiveness of Pharmaceutical Treatments for Obesity within the Veterans Health Administration. Pharmacother J Hum Pharmacol Drug Ther. enero de 2018;38(1):19-28.
Grunvald E, Shah R, Hernaez R, Chandar AK, Pickett-Blakely O, Teigen LM, et al. AGA Clinical Practice Guideline on Pharmacological Interventions for Adults With Obesity. Gastroenterology. noviembre de 2022;163(5):1198-225.
Néspola ML, Acosta Sero MO. Evolution of micronutrient status in morbidly obese adults undergoing bariatric surgery. SCT Proceedings in Interdisciplinary Insights and Innovations. 2024; 2:354. https://doi.org/10.56294/piii2024354
Caballero MJ, Boyne G. The growing problem of overweight and obesity in childhood: Systematic review of literature. AG Salud. 2023; 1:54. https://doi.org/10.62486/agsalud202454
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Juan José Izquierdo Miranda, Marcelo Adrián Estrín (Author)