topiramate/phentermine / Generic mfg. - LARVOL DELTA

FibroScan Outcomes of Phentermine/Topiramate in MASLD: A Head-to-Head Comparison With GLP-1 Receptor Agonists in a Real-World Weight Management Cohort (ACG 2026) - " We performed a retrospective, single-center analysis (January 2015âOctober 2025) of weight management clinic patients with MASLD (CAP â¥275 dB/m, â¥1 cardiometabolic risk factor, no alcohol use disorder) receiving GLP-1 RA monotherapy (semaglutide, liraglutide, or tirzepatide; n=33) or PT monotherapy (n=24) without concomitant weight-loss medications (Table 1). GLP-1 RA achieved significant intragroup reductions in CAP (â46.5±83.8 dB/m, p=0.007), LS (â1.78±8.68 kPa, p=0.048), and weight (â10.82±14.10 kg, p< 0.001) (Table 2). PT did not achieve significant changes in CAP (+2.5±46.0, p=0.865), LS (â1.00±4.69 kPa, p=0.551), or weight (â4.88 kg, p=0.069), although there was a trend towards weight loss. Between-group differences showed a trend favoring GLP-1 RAs for CAP (p=0.064) but were non-significant for all outcomes."

Clinical • Head-to-Head • Real-world • Real-world evidence • Addiction (Opioid and Alcohol) • Fibrosis • Immunology • Metabolic Dysfunction-Associated Steatotic Liver Disease

Do All Weight-Loss Drugs Benefit the Liver? Real-World FibroScan Outcomes Across FDA-Approved Anti-Obesity Pharmacotherapies in MASLD (ACG 2026) - " Retrospective, single-center analysis (January 2015âOctober 2025) was performed of patients from a weight management clinic who received at least one FDA-approved weight-loss medication (liraglutide, semaglutide, tirzepatide, phentermine, phentermine/topiramate, or bupropion/naltrexone), and underwent serial VCTE (FibroScan). Among 219 patients meeting MASLD criteria, all groups achieved significant intragroup CAP reductions: GLP-1 only (â46.5±83.8 dB/m, p=0.007), Combination (â54.4±86.4, p< 0.001), and Non-GLP-1 (â30.1±57.8, p=0.002) (Table 2). Significant LS reductions were observed in GLP-1 (â1.8±8.7 kPa, p=0.048) and Combination (â1.9±13.5 kPa, p=0.003) groups, but not Non-GLP-1 (p=0.376). Intergroup differences were not significant (ÎCAP p=0.418; ÎLS p=0.102)."

Clinical • Real-world • Real-world evidence • Addiction (Opioid and Alcohol) • Fibrosis • Genetic Disorders • Hepatology • Immunology • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Obesity

The Association Between Glucagon-Like Peptide-1 Receptor Agonists Use and Liver Outcomes in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease Without Diabetes (ACG 2026) - "A cohort of adults with MASLD and without diabetes who initiated GLP-1RA were compared to those who initiated orlistat, phentermine-topiramate, or naltrexone-bupropion (non GLP-1RA anti-obesity medication users). After matching, 9056 pairs of GLP-1RA users and non GLP-1RA anti-obesity medication users were analyzed. GLP-1RA use was associated with a significantly reduced risk of decompensated cirrhosis events (HR 0.692, 95% CI 0.496-0.965, p=0.029) within 5 years. Specifically, GLP-1RA use was associated with lower risks of ascites-related complications (HR 0.538, 95% CI 0.367-0.790, p=0.001)."

Clinical • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Coronary Artery Disease • Diabetes • Fibrosis • Gastroenterology • Genetic Disorders • Heart Failure • Hepatic Encephalopathy • Hepatocellular Cancer • Hepatology • Hypertension • Immunology • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Nephrology • Obesity • Renal Disease • Solid Tumor • Type 2 Diabetes Mellitus • Vascular Neurology

Obesity Treatment With Phentermine-Topiramate ER in AYA Surviving Leukemia and Lymphoma (clinicaltrials.gov) - P2 | N=100 | Not yet recruiting | Sponsor: St. Jude Children's Research Hospital | N=45 ➔ 100

Enrollment change • Acute Lymphocytic Leukemia • Genetic Disorders • Hematological Malignancies • Hodgkin Lymphoma • Leukemia • Lymphoma • Non-Hodgkin’s Lymphoma • Obesity • Oncology

Economic evaluations of antiobesity medications: A systematic literature review. (PubMed, Br J Clin Pharmacol) - "We systematically reviewed full economic evaluations of approved antiobesity medications in adults with overweight or obesity, including tirzepatide, semaglutide, liraglutide, naltrexone/bupropion, orlistat, phentermine and phentermine/topiramate. Direct comparative economic evidence between newer agents remains limited. Long-term real-world data and clearer distinctions between cost-effectiveness and affordability are needed to inform policy decisions."

HEOR • Journal • Review • Genetic Disorders • Obesity

Pharmacological management of obesity: Current landscape and emerging therapies. (PubMed, Indian J Pharmacol) - "Currently, six medications (Orlistat, Phentermine/Topiramate, Naltrexone/Bupropion, Liraglutide, Semaglutide, and Tirzepatide) are approved by the U.S. Food and Drug Administration for long-term obesity management and among these, glucagon-like peptide receptor agonists have revolutionized the therapy...It has new dual and triple combinations such as CagriSema, Survodutide, and Retatrutide for better efficacy and metabolic outcomes, as well as long-acting and oral formulations, which will improve adherence and accessibility. India released its new obesity guideline in January 2025, emphasizing on early pharmacotherapy initiation and the adoption of stage-based obesity classification. Together, these developments signify a transformative era in obesity care where pharmacotherapy is a powerful and evidence-based tool that, in many cases, approaches the efficacy and metabolic benefits traditionally associated with bariatric surgeries."

Journal • Review • Cardiovascular • CNS Disorders • Diabetes • Genetic Disorders • Hepatology • Metabolic Disorders • Obesity • Psychiatry • Type 2 Diabetes Mellitus

Super-Additive Weight Loss From Combining Melanocortin Receptor Agonism With Phentermine/Topiramate (OBESITY WEEK 2026) - No abstract available

Therapeutic Potential of Anti-Obesity Drugs in Obesity-Associated Female Reproductive Dysfunction: Translating Mechanistic Evidence into Personalized Clinical Strategies. (PubMed, Medicina (Kaunas)) - "Evidence suggests that several FDA-approved and off-label anti-obesity agents, including orlistat, liraglutide, semaglutide, phentermine/topiramate, bupropion/naltrexone, metformin, exenatide, and tirzepatide, may improve reproductive outcomes primarily indirectly through weight reduction and metabolic improvement...However, evidence for several agents remains limited, and concerns persist regarding reproductive safety during pregnancy. Overall, anti-obesity pharmacotherapy may represent an important adjunctive strategy for improving reproductive and metabolic health in women with obesity, although larger randomized clinical trials are still required."

Clinical • Journal • Review • Diabetes • Genetic Disorders • Gestational Diabetes • Gynecology • Infertility • Inflammation • Metabolic Disorders • Obesity • Polyendocrine Metabolic Ovarian Syndrome • Sexual Disorders • Women's Health • LEP

Obesity Treatment Using Phentermine-Topiramate ER to Improve Metabolic Health in Adolescents Surviving Leukemia and Lymphoma (clinicaltrials.gov) - P2 | N=45 | Not yet recruiting | Sponsor: St. Jude Children's Research Hospital

New P2 trial • Acute Lymphocytic Leukemia • Genetic Disorders • Hematological Malignancies • Hodgkin Lymphoma • Leukemia • Lymphoma • Non-Hodgkin’s Lymphoma • Obesity • Oncology

Combination Pharmacotherapies for Obesity-Current Evidence and Future Directions. (PubMed, Endocrinol Diabetes Metab) - "Available data suggest that combination pharmacotherapy can extend current approaches to precision obesity care, generally providing additive benefits alongside increased regimen complexity, costs and adverse-event risks. Thoughtful, phenotype-guided selection and comparative studies versus potent monotherapies, enriched by multi-omics and behavioural insights, may clarify which patients benefit most and sustainably from these strategies."

Journal • Review • Cardiovascular • Genetic Disorders • Obesity • Psychiatry

Projected budget impact of pharmacotherapy scenarios for obesity and related conditions in Peru: A national survey analysis of 76,819 participants. (PubMed, Obes Pillars) - "Liraglutide 3.0 mg and semaglutide 2.4 mg represent high-cost non-governmental retail scenarios rather than expected institutional procurement estimates. Extended-release naltrexone/bupropion provides a lower-cost non-GLP-1 comparator,and extended-release phentermine/topiramate was analyzed only as an exploratory supplementary comparator."

HEOR • Journal • Genetic Disorders • Obesity

Cancer risk of glucagon-like peptide-1 receptor agonists for obesity: comparison with bariatric surgery and other weight-loss drugs. (PubMed, J Gastrointest Surg) - "Therapeutic-dose GLP-1 RA use was associated with a lower incidence of CRC and pancreatic cancer compared with bariatric surgery and with a lower incidence of CRC compared with other weight-loss medications. These findings suggest that GLP-1 RA use is not associated with an increased cancer risk and raise the possibility that therapeutic-dose treatment may be associated with a lower cancer incidence."

Journal • Colorectal Cancer • Genetic Disorders • Hepatocellular Cancer • Liver Cancer • Metabolic Disorders • Obesity • Oncology • Pancreatic Cancer • Solid Tumor

Respiratory Adverse Events of Weight-Loss Drugs: A Systematic Review and Meta-Analysis. (PubMed, Ann Am Thorac Soc) - "There was no evidence of increased respiratory harm associated with weight-loss drugs compared with placebo, suggesting a reassuring respiratory safety profile in the general population. However, evidence specifically focused on individuals with asthma remains limited."

Adverse events • Journal • Retrospective data • Asthma • Genetic Disorders • Immunology • Infectious Disease • Obesity • Pulmonary Disease • Respiratory Diseases

Comparative effects of drugs for adults with overweight or obesity: systematic review and network meta-analysis. (PubMed, BMJ) - "Obesity drugs produce variable weight loss at one year, with larger benefits generally accompanied by greater harms and discontinuation. Most agents do not improve quality of life meaningfully and few show cardiovascular benefits. Decisions in clinical practice should consider trade-offs between benefits and harms within the context of shared decision making."

Clinical • Journal • Retrospective data • Review • Cardiovascular • Congestive Heart Failure • Fatigue • Genetic Disorders • Heart Failure • Myocardial Infarction • Obesity • Renal Disease

Neuropsychiatric association of tirzepatide and semaglutide in obesity with and without type 2 diabetes. (PubMed, Commun Med (Lond)) - "Initiation of tirzepatide and semaglutide is associated with differing hazard patterns across prescription comparators, with bariatric surgery providing additional context. These findings inform monitoring and shared decisions, while remaining subject to residual confounding and diagnosis misclassification."

Journal • CNS Disorders • Depression • Diabetes • Genetic Disorders • Insomnia • Metabolic Disorders • Obesity • Psychiatry • Sleep Disorder • Type 2 Diabetes Mellitus

Cost-Effectiveness of Pharmacologic Treatments in Adults With Overweight or Obesity: A Systematic Review for the American College of Physicians. (PubMed, Ann Intern Med) - "In the 6 studies with moderate certainty, liraglutide had low value and phentermine-topiramate and tirzepatide had high value when each was compared with lifestyle modification. American College of Physicians. (PROSPERO: CRD42023491646)."

HEOR • Journal • Review • Genetic Disorders • Obesity

Real-World Treatment Patterns and Goals of Adolescents Living with Obesity in the US Population: Results from a Multinational Cross-sectional Survey (UNICORN) (ENDO 2026) - "Among AwO on pharmacotherapy (n=405), the most frequently prescribed included semaglutide (55.1%), metformin (21.5%), phentermine/topiramate (9.6%), and tirzepatide (6.9%)...Conclusion This analysis highlights the treatment journey for AwO and key considerations physicians make when determining which obesity management strategies to initiate for AwO. Physicians' concerns about the success of current treatment options underscore the need for better approaches to achieve weight loss and treatment goals in AwO."

Clinical • HEOR • Late-breaking abstract • Real-world • Real-world evidence • Diabetes • Genetic Disorders • Metabolic Disorders • Obesity • Type 2 Diabetes Mellitus

Benefits and Harms of Pharmacologic Treatments in Adults With Overweight or Obesity: A Living Systematic Review and Network Meta-analysis for the American College of Physicians. (PubMed, Ann Intern Med) - "Randomized controlled trials that compared pharmacologic treatments for weight management (dulaglutide, exenatide, liraglutide, lixisenatide, naltrexone-bupropion, orforglipron, phentermine, phentermine-topiramate, retatrutide, semaglutide, semaglutide-cagrilintide, tirzepatide, or any combination with or without lifestyle intervention [LI]) for overweight or obesity (body mass index ≥25 kg/m2) in adults for outcomes such as mortality, weight loss, and quality of life...American College of Physicians. (PROSPERO: CRD42023491646)."

Journal • Retrospective data • Review • Cardiovascular • Coronary Artery Disease • Diabetes • Genetic Disorders • Heart Failure • Metabolic Disorders • Obesity • Type 2 Diabetes Mellitus

Pharmacologic Treatments With Lifestyle Modifications in Nonpregnant Adults With Overweight or Obesity in Outpatient Settings: A Living Clinical Guideline From the American College of Physicians (April 2026). (PubMed, Ann Intern Med) - "ACP suggests initiating one of the following pharmacologic treatments with lifestyle modifications for weight management in nonpregnant adults with obesity (body mass index ≥30 kg/m2) in outpatient settings (conditional recommendation): First-line treatments are semaglutide (moderate-certainty evidence) and tirzepatide (moderate-certainty evidence); second-line treatment is phentermine-topiramate (low-certainty evidence); third-line treatment is liraglutide (low-certainty evidence); fourth-line treatment is naltrexone-bupropion (low-certainty evidence)...ACP suggests initiating one of the following pharmacologic treatments with lifestyle modifications for weight management in nonpregnant adults with overweight (body mass index ≥27 to 30 kg/m2) and type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, or cardiovascular disease (conditional recommendation): First-line treatments are semaglutide (moderate-certainty evidence) and tirzepatide..."

Clinical guideline • Journal • Cardiovascular • Diabetes • Dyslipidemia • Genetic Disorders • Hypertension • Metabolic Disorders • Obesity • Obstructive Sleep Apnea • Psychiatry • Respiratory Diseases • Sleep Disorder • Suicidal Ideation • Type 2 Diabetes Mellitus

Association between Semaglutide and Risk of Bone Fractures in Type 2 Diabetes (ENDO 2026) - "Aim: This study aims to evaluate fracture incidence and body mass index (BMI) changes among T2D patients treated with semaglutide compared to those treated with dulaglutide or alternative weight loss drugs (phentermine/topiramate, bupropion/naltrexone). In T2D patients, semaglutide was associated with a 15% reduction in fracture incidence and greater weight loss compared to another GLP-1RA and alternative weight-loss therapies. These findings highlight potential bone-protective effects of semaglutide, though prospective studies are needed to confirm findings."

Diabetes • Infectious Disease • Metabolic Disorders • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Type 2 Diabetes Mellitus

Impact of Anti-Obesity Medications on Skeletal Muscle Mass and Body Composition in Patients with Hormone Receptor-Positive Breast Cancer Receiving Concurrent Endocrine Therapy (ENDO 2026) - "ET therapies at initiation of anti-obesity therapy: anastrozole (n=26), tamoxifen (n=7), exemestane (n=4), and letrozole (n=2), with a median ET duration of 38 months (range 5–108)...GLP-1 RA's included tirzepatide (n=24), semaglutide (n=11), and liraglutide (n=3); oral agents were phentermine ± topiramate (n=11)...Limitations include use of body composition analyzer scales versus DEXA & grouping of agents together. Prospective studies are needed to assess long-term efficacy & better characterize sarcopenia in this population."

Clinical • Breast Cancer • Dyslipidemia • Genetic Disorders • HER2 Breast Cancer • HER2 Positive Breast Cancer • Hormone Receptor Breast Cancer • Hormone Receptor Positive Breast Cancer • Metabolic Disorders • Obesity • Oncology • Sarcopenia • Solid Tumor • Type 2 Diabetes Mellitus

Phentermine/Topiramate in Obese, Diabetic Uric Acid Stone Formers: An Open-Label Randomized Feasibility Trial. (PubMed, J Urol) - "Intervention group also had greater weight loss, higher urinary pH, and lower HgbA1c and urinary citrate levels. This data provides a framework to study the impact of this novel alternative UA therapy on a wider range of obese and diabetic patients."

Journal • Diabetes • Genetic Disorders • Metabolic Disorders • Nephrology • Obesity • Renal Calculi • Type 2 Diabetes Mellitus

Integrated docking, molecular dynamics, and Markov state modelling reveal epigenetic target engagement by anti-obesity drugs. (PubMed, J Biomol Struct Dyn) - "Overall, orlistat-followed by topiramate and phentermine-most effectively stabilized catalytically relevant conformations. These findings indicate that certain anti-obesity drugs may exert epigenetic effects, influencing adipocyte function and metabolic regulation, warranting further experimental validation."

Journal • Genetic Disorders • Metabolic Disorders • Obesity • DNMT3A • HDAC3

Obesity Management Pharmacotherapies and Lifestyle Treatment for Pediatric Obesity Management: A Systematic Review and Network Meta-Analysis. (PubMed, JAMA Pediatr) - "Interventions included lifestyle treatment (HBLT and counseling), obesity management pharmacotherapies (glucagon-like peptide-1 receptor agonists, metformin, orlistat, phentermine topiramate), or their combination vs control. HBLT remained an indispensable component of any effective weight management, delivering meaningful weight loss and healthier body composition on its own. Combined with lifestyle treatment, pharmacotherapy was a key component, not solely an adjunct, associated with the greatest BMI and BMI z score improvements, and long-term sustainability and safety were monitored."

Clinical • Journal • Retrospective data • Genetic Disorders • Obesity • Pediatrics

Long-term effects of weight-reducing drugs in people with hypertension. (PubMed, Cochrane Database Syst Rev) - "There have been multiple developments in the domain of medications for long-term weight reduction in recent years. Several pharmaceutical products have been removed from the market due to safety concerns, whilst new drugs have been introduced. Our critical outcomes of death and cardiovascular complications were not the focus of the trials included in this review but were sometimes presented as part of an 'adverse events' outcome, with the resultant data providing only very low certainty evidence. Overall, the evidence for people with hypertension remains insufficient to draw conclusions regarding the benefits of pharmacological weight loss in terms of reducing the risk of mortality or cardiovascular morbidity. Further trials are needed. Moreover, separate results for participants with hypertension should be made available from any completed trials involving both normotensive and hypertensive people."

Clinical • Journal • Review • Cardiovascular • Hypertension • Obesity