Friday, December 20, 2019

The Combination Drug Phentermine-Topiramate May be Useful in Treating Childhood Obesity

The weight loss drug, Qsymia, is one of the five anti-obesity drugs approved by the Federal Drug Administration or the FDA for long term use. The other drugs given FDA approval are Xenical, Saxenda, Contrave and Belviq. Qsymia was developed by a company based in California called Vivus. The anti-obesity drug gained FDA approval in 2012. Qsymia is a combination of two other drugs. They are phentermine and topiramate.
The combination-drug is approved for adults with a BMI greater than or equal to 30, or for adults with a BMI greater than or equal to 27, when the adults have at least one comorbidity such as high blood pressure type 2 diabetes or high cholesterol. However, at least one study indicates that the combination of phentermine and topiramate may be appropriate for the treatment of childhood obesity.

The study was a multicenter randomized control study consisting of obese adolescents 12 to 17 years of age. For the study, 42 adolescents were randomly assigned to a placebo group and two other phentermine-topiramate groups. One of the phentermine-topiramate groups was given a low dose of the phentermine-topiramate combination. The dose was 7.5 mg of phentermine and 46 mg of topiramate. The other phentermine-topiramate group was given 15 mg of phentermine and 92 mg of topiramate for the combination dose.

The investigators concluded that: "Treatment of adolescents with obesity using a fixed-dose combination of phentermine/topiramate for 8 weeks resulted in exposure to [phentermine and topiramate] that was comparable to that observed in adults, statistically significant weight loss, and a tolerable safety profile. These data indicate that both mid- and top-doses  are appropriate for longer term safety and efficacy studies in adolescents.”

Since obesity is a problem for children as well as adults, perhaps some consideration should be given to making the combination drug, phentermine-topiramate, available for adolescent use. The drug could only add to the arsenal of tools that are now being used to fight childhood obesity.


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