Objective: This study aims to see whether patients in a real-world setting taking topiramate for varied indications experience significant weight loss. Methods: This was a retrospective cohort study from the Veterans Affairs San Diego Healthcare System. Patients were new topiramate users between January 1, 2000 and December 31, 2013 with body mass index > 25 kg/m(2) and medication possession ratio > 0.5. Primary outcome determined if topiramate users experienced significant changes in weight and body mass index. Secondary outcome analyzed predictive factors associated with 5% weight loss using logistic regression models. Patients were followed up 1 year post index date. Results: A total of 767 patients were included in the final analysis. Patients lost an average of 5.6 lbs (216.1 lbs preweight vs. 210.5 lbs postweight) at an average follow-up of 7.8 months. A total of 43.2% (92/213) of females lost 5% of their body weight compared to 29.4% (163/554) of males. Females (odds ratio 1.73; 95% confidence interval 1.21-2.48; p = 0.003), topiramate indication other than headache, and adherent patients (odds ratio 1.78; 95% confidence interval 1.28-2.49; p = 0.001) were more likely to lose 5% of body weight. Conclusion: Topiramate should be considered with higher priority in overweight and obese patients for nonweight loss indications for dual benefit.
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机译：目的：本研究旨在观察在现实环境中服用托吡酯用于各种适应症的患者是否体重减轻。方法：这是退伍军人事务圣地亚哥医疗系统的一项回顾性队列研究。在2000年1月1日至2013年12月31日期间，患者是托吡酯的新使用者，体重指数> 25 kg / m（2），药物拥有率> 0.5。主要结局决定了托吡酯使用者的体重和体重指数是否发生显着变化。次要结局使用逻辑回归模型分析了与5％体重减轻相关的预测因素。索引日期后1年对患者进行随访。结果：最终分析共纳入767例患者。患者平均随访7.8个月，平均减轻5.6磅（体重前为216.1磅，体重后为210.5磅）。共有43.2％（92/213）的女性失去了5％的体重，而男性的这一比例为29.4％（163/554）。女性（赔率1.73; 95％置信区间1.21-2.48; p = 0.003），除头痛外的托吡酯适应症和依从性患者（赔率1.78; 95％置信区间1.28-2.49; p = 0.001）更容易丢失体重的5％。结论：对于超重和肥胖患者，应优先考虑托吡酯，因为非减肥指征具有双重益处。
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