Giving patients a combination of low-dose, controlled-release phentermine plus topiramate could be a much-needed and valuable adjunct to labor-intensive, office-based diet and lifestyle interventions for the management of obesity. "A greater understanding of obesity, and effective treatment strategies, is critical to addressing [the obesity] epidemic. New tools have not been forthcoming, so promising therapies are really exciting for the field," explains Kishore Gadde, lead author on the multicenter phase 3 CONQUER trial.Phentermine was approved by the FDA for short-term treatment of obesity in 1959, but no randomized controlled trials have reported its use in the long term. By contrast, topiramate is approved for the treatment of epilepsy and migraine prophylaxis; its effect on weight reduction in obese patients with or without type 2 diabetes and hypertension has been studied, but its potential as a monotherapy for obesity has been held back by associated dose-dependent neuropyschiatric adverse events.
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