Two-drug combo increases diabetes patients’ goal achievement

By Sarah Guy

Post-hoc analysis of randomized trial results shows that treating individuals with Type 2 diabetes (T2D) with a combination of phentermine (PHEN) and topiramate (TPM ER) increases their achievement of goals recommended for the management of their condition.

PHEN and TPM ER are both agents used alongside dietary modification for weight loss, explains an accompanying press release to the study, which was presented at the 94th Annual Meeting and Expo of The Endocrine Society in Houston, Texas, USA.

Significantly more patients who were treated with the drug combination achieved weight loss of more than 5.0%, as well as a reduction of glycated hemoglobin (HbA1c) to less than 6.5% and systolic blood pressure (SBP) to less than 130 mm/Hg (composite goal [CG] A), compared with those who received a placebo.

"This shows that medications to help reinforce the behaviors to produce weight loss can actually help patients achieve better diabetes management while achieving more goals than just A1c," said study co-author Donna Ryan, from Louisiana State University in Baton Rouge, USA, in a press briefing.

Ryan and colleagues analyzed 357 T2D participants of the CONQUER (effects of low-dose, controlled-release, PHEN plus TPM ER combination on weight and associated comorbidities in overweight and obese adults) study, of whom 144 were randomly assigned to receive a lifestyle intervention plus placebo, or lifestyle intervention plus one of two doses of PHEN/TPM ER: 7.5 mg/46 mg (n=63), or 15.0 mg/92 mg (n=150).

After 56 weeks of the study, the researchers found that 11.8%, 27.0%, and 39.3% of placebo, lower-, and higher-dose PHEN/TPM ER patients, respectively, achieved CG A, which were all significant differences.

Furthermore, significantly more combination therapy-treated patients achieved CG B - weight loss more than 10%, HbA1c less than 6.5%, and SBP less than 130 mm/Hg - than placebo-treated patients, at a respective 4.2% and 14.3% for the lower and higher doses, versus 31.3%.

The most common adverse events reported by the participants were constipation and paresthesia, and discontinuation of the study occurred in 8%, 9%, and 19%, of placebo, low- and high-dose PHEN/TPM ER patients, respectively, because of adverse events.

No instances of hypoglycemia led to study discontinuation, report the authors.

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