Issue: August 2012
August 09, 2012
2 min read

Phentermine topiramate led to long term weight loss reduced systolic BP in type 2 diabetes

Issue: August 2012
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HOUSTON — Extended-release phentermine/topiramate induced weight loss that led to improvements in HbA1c and systolic blood pressure 56 weeks after treatment, according to data from a post-hoc analysis of the CONQUER study.

Donna H. Ryan, MD, presented results of the analysis at the Endocrine Society’s 94th Annual Meeting and Expo.

“With over 25 million adults with type 2 in the US and a vast majority of them being obese, the management of these patients touches everyone in medicine,” Ryan said during her presentation. “Our current goals for management of these patients include weight loss >7%, reduction of HbA1c to <6.5% and a reduction in systolic blood pressure to <130 mm Hg.”

Donna H. Ryan

The 56-week, randomized CONQUER study included overweight/obese patients with two or more weight-related comorbidities who were assigned to one of two doses of extended-release phentermine/topiramate (PHEN/TPM ER) or placebo. Results of the study demonstrated significant weight loss with PHEN/TPM ER.

The current analysis by Ryan and colleagues examined the percentage of participants included in CONQUER who had type 2 diabetes at baseline and achieved these composite goals by week 56: A) weight loss >5%; HbA1c >6.5%; systolic BP <130 mm Hg; and B) weight loss >10%; HbA1c <6.5%; systolic BP <130 mm Hg.

They also identified the percentage of patients with net changes in concomitant antidiabetic and antihypertensive treatments at 56 weeks.

Their analysis included 357 patients with type 2 diabetes at baseline and one or more post-baseline assessments of weight loss, HbA1c and systolic BP, including 144 patients assigned to placebo; 63 assigned to 7.5 mg PHEN and 46 mg TPM ER and 150 assigned to 15 mg PHEN and 92 mg TPM ER.

Two-thirds of patients were female; mean age was 52.6 years; mean weight was 100.9 kg; mean HbA1c was 6.8% and 70.8% were using metformin; and mean systolic BP was 125.9 mm Hg at baseline.

At 56 weeks, among the placebo group, 11.8% achieved composite goals A and 4.2% achieved composite goals B; 27% of the 7.5 PHEN/46 mg TPM ER group achieved composite goals A and 14.3% achieved composite goals B; 39.3% of the 15 mg PHEN/92 mg TPM ER group achieved composite goals A and 31.3% achieved composite goals B (P<.0001 between treatment groups).

Net change in concomitant antidiabetic and antihypertensive treatment was decreased among patients treated with PHEN/TPM ER, and neutral or increased among those assigned to placebo.

“To conclude, at week 56, we saw that the addition of PHEN/TPM ER to lifestyle modification led to significant weight loss, compared with placebo. Individuals who took PHEN/TPM ER along with lifestyle intervention had a statistically higher rate of achievement of composite goals and were able to reduce antihypertensive medications and did not have to increase their antidiabetic medications to achieve these goals,” Ryan said. – by Stacey L. Fisher

  • Dr. Ryan is a consultant for Vivus USA, Novo Nordisk and Takeda.