Long-term weight loss with controlled-release phentermine/topiramate appears to reverse metabolic syndrome and improve associated traits, according to results released at the 47th European Society for the Study of Diabetes (EASD) Annual Meeting.

Hermann Toplak, MD, Medical University of Graz in Graz, Austria, and colleagues evaluated the long-term effects of controlled-release phentermine/topiramate as an adjunct to lifestyle intervention on weight loss and the metabolic syndrome over 108 weeks.

The study population included patients with metabolic syndrome at baseline in the CONQUER study. In the 56-week CONQUER study, low-dose, controlled-release phentermine/topiramate, when added to lifestyle interventions, demonstrated significant weight loss and resolution of metabolic syndrome.

Dr. Toplak pointed out that the incidence of metabolic syndrome has been increasing worldwide, probably as a result of the increased rate of obesity. Both metabolic syndrome and obesity are risk factors for type 2 diabetes.

Weight loss has been proposed as the first-line intervention for metabolic syndrome and its associated components, he said.

Results of the present analysis showed that in patients who had metabolic syndrome but not type 2 diabetes at baseline, weight loss was significantly greater with controlled-release phentermine/topiramate than with placebo. Also, weight loss was maintained over 108 weeks.

More than twice as many patients treated with controlled-release phentermine/topiramate had resolution of metabolic syndrome versus placebo. In addition, fewer patients without metabolic syndrome at baseline progressed to metabolic syndrome with controlled-release phentermine/topiramate than placebo.

In this population of patients with metabolic syndrome at baseline, controlled-release phentermine/topiramate produced larger reductions in fasting blood glucose and insulin than placebo, which indicates an increase in insulin sensitivity. The active drug was also associated with decreases in waist circumference, blood pressure, and triglycerides, and increases in high-density lipoprotein (HDL)-cholesterol.

Controlled-release phentermine/topiramate was generally well tolerated.

Dr. Toplak said that the results suggest that controlled-release phentermine/ topiramate on top of lifestyle intervention may be useful for combating both the obesity epidemic and the underlying pathophysiology that leads to the progression of cardiometabolic disease.

Written by Jill Stein
Jill Stein is a Paris-based freelance medical writer.