topiramate/phentermine / Generic mfg. - LARVOL DELTA

Signal identification of adverse reactions related to phentermine/topiramate: A study based on FAERS reports. (PubMed, Obes Res Clin Pract) - "The phentermine/topiramate combination demonstrates significant efficacy for weight loss; however, its adverse reaction profile is varied in type and severity, with some events not explicitly listed in the prescribing information, underscoring the need for cautious clinical application."

Journal • CNS Disorders • Genetic Disorders • Metabolic Disorders • Obesity • Ophthalmology • Polycystic Ovary Syndrome • Psychiatry

A meta-analysis of efficacy and safety of anti-obesity medications in the treatment of childhood obesity (PubMed, Zhonghua Yi Xue Za Zhi) - "Objective: To evaluate the efficacy and safety of orlistat, glucagon-like peptide-1 receptor agonists (GLP-1RA), and the combination of phentermine and topiramate in the treatment of childhood obesity. After 12 weeks of treatment, both phentermine monotherapy (mean difference=-1.4 kg) and phentermine combined with topiramate (mean difference=-3.9%) resulted in lower weight compared to the placebo group (both P<0.05), with a low incidence of serious adverse events. Orlistat, GLP-1RA (liraglutide and semaglutide), fenfluramine combined with topiramate demonstrate favorable efficacy and safety profiles in the treatment of childhood obesity."

Journal • Retrospective data • Constipation • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Obesity • Pain

Weight Loss Outcomes with Tirzepatide in Patients with Previous Obesity Medication Use (OBESITY WEEK 2025) - "Secondary endpoints included: (i) comparison of TBWL% between patients previously exposed to Glucagon-Like Peptide-1 receptor agonists (GLP-1 RAs; I.E., semaglutide and liraglutide) versus non-GLP-1 RAs (phentermine/topiramate ER, phentermine, naltrexone/bupropion SR, and orlistat) and (ii) comparison of TBWL% between patients with recent OM exposure (3 months). Prior exposure to OMs, particularly GLP-1RAs, was associated with inferior weight loss outcomes with tirzepatide in our cohort. This highlights the importance of considering prior medication history when prescribing tirzepatide for weight management, especially in the context of insurance-related barriers. Further prospective studies are warranted to confirm these findings and explore potential mechanisms driving these differences."

Clinical • Genetic Disorders • Obesity

Prevalence of Obesity Medications in the Military Health System: An Update from 2022 (OBESITY WEEK 2025) - "Any medications whose primary use was for type 2 diabetes (e.g. Ozempic, Victoza, Mounjaro) were excluded...The most commonly used OMs were Phentermine (45.8%), Wegovy (25.3%), Contrave (19.5%), Qsymia (15.1%), and Zepbound (13.6%)... Despite modest increases in OM utilization within the MHS, overall rates remain low, particularly among active-duty and certain racial and ethnic groups. These findings highlight persistent disparities and suggest a continued need to address policy, access, and provider-level barriers to equitable obesity care."

Cardiovascular • Chronic Kidney Disease • Coronary Artery Disease • Genetic Disorders • Metabolic Disorders • Nephrology • Obesity • Obstructive Sleep Apnea • Renal Disease • Respiratory Diseases • Sleep Apnea • Sleep Disorder • Type 2 Diabetes Mellitus

When to Start and How to Adjust Pharmacotherapy for Adolescent Severe Obesity: A Randomized Trial (OBESITY WEEK 2025) - "Background: Although pharmacotherapy, such as phentermine and topiramate, is recommended as adjuncts to health behavior and lifestyle therapy (HBLT) for adolescent obesity treatment, guidance is unclear regarding when in the course of treatment medications should be started and how they should be modified if response is suboptimal... There was no difference in BMI outcomes between assessing HBLT response at 12 weeks vs waiting until 24 weeks. Further, for adolescents who were suboptimal responders to phentermine 15 mg, BMI outcomes were better if topiramate 100 mg was added rather than switched to topiramate monotherapy. Future trials should investigate whether earlier response assessments (i.e., <12 weeks) with earlier initiation of pharmacotherapy would produce superior outcomes."

Clinical • Genetic Disorders • Obesity

Hypothalamic Obesity Nonresponse to Monotherapy Successfully Treated with Glp1 Plus Phentermine (OBESITY WEEK 2025) - "Here we present two cases of patients with HO that had previously tried phentermine or liraglutide/tirzepatide without success who experienced significant improvement in obesity after initiation of combination therapy... These two cases highlight patients with HO who did not respond to GLP1 monotherapy but were able to subsequently lose significant amounts of weight and reported significant improvements in HO hyperphagia, with an average weight loss of 24.2% TBW on combination therapy with Tirzepatide plus phentermine or phentermine/topiramate... Treatment options for individuals with HO are limited. This case series highlights the potential for improved clinical outcomes in this disorder with combination of two different AOM mechanisms. Larger studies and analyses may help better delineate safety and efficacy of combination therapy in HO."

Monotherapy • Endocrine Disorders • Fibrosis • Genetic Disorders • Hepatology • Hypothalamic Injury-associated Obesity • Immunology • Obesity

A Closer Look at FDA Trials: Safety and Efficacy of GLP-1 vs Non-GLP-1 for Obesity and Diabetes (OBESITY WEEK 2025) - " We reviewed US FDA Medical and Statistical reports (https://www.accessdata.fda.gov/), focusing on approved GLP-1 weight loss (WM) drugs liraglutide, semaglutide, tirzepatide, and non-GLP-1 agents orlistat, phentermine/topiramate. We also reviewed GLP-1 type 2 diabetes (T2D) drugs semaglutide, tirzepatide, exenatide, lixisenatide, albiglutide... This review of FDA medical and statistical reports suggests that GLP-1 agents, when compared to non-GLP-1 medications for weight management and to placebo in both weight loss and Type 2 diabetes trials, are associated with comparable or lower mortality rates and greater weight reduction. Mortality per patient-exposure year was consistently lower in treatment groups receiving GLP-1 agents. Weight loss outcomes were also more pronounced with GLP-1 therapies across indications."

Clinical • Diabetes • Genetic Disorders • Metabolic Disorders • Obesity • Type 2 Diabetes Mellitus

Guidance for Obesity Management: What About the Patient's Experience? (OBESITY WEEK 2025) - " Six OMMs have FDA approval: orlistat, phentermine-topiramate, naltrexone and bupropion, liraglutide, semaglutide, and tirzepatide. Qualitative data are valued by US regulators to capture patients' experiences with OMMs and to support the content validity and interpretability of COA endpoints. Well-designed in-trial research studies may help overcome some of the challenges and concerns posed by the FDA."

Clinical • Genetic Disorders • Obesity

Healthcare Cost & Use Trajectories of Patients Prescribed Phentermine vs. Newer Obesity Medications (OBESITY WEEK 2025) - " Using a nationwide commercial claims dataset spanning 2012-2023, we identified cohorts of incident users of phentermine (n=133,460), phentermine-topiramate-ER (n=13,967), bupropion-naltrexone-SR (n=28,693), and the obesity-labeled version of liraglutide (n=48,953)... Compared to generic phentermine, initiation of second and early third generation OMs was associated with a sizeable increase in annual healthcare costs up to 3 years after starting treatment, with prescription drug prices driving much of the increase. Acute care use was largely similar across groups, suggesting no increased risk of serious adverse events for phentermine users. These findings support the current use of phentermine as a first-line agent to contain population-level cost impacts of newer OMs."

Clinical • HEOR • Cardiovascular • Diabetes • Genetic Disorders • Hypertension • Metabolic Disorders • Obesity • Type 2 Diabetes Mellitus

Disparities in Obesity Medication Dispensing Among Adolescents in Real-World Settings (OBESITY WEEK 2025) - "We included commonly prescribed OMs in our healthcare system, including Semaglutide, Liraglutide, Tirzepatide, Phentermine, Topiramate, Phentermine-Topiramate, Metformin, and Lisdexamfetamine... This is the first study to examine the likelihood of OM dispensing in a pediatric population. We identified stark disparities in whether an OM was dispensed by insurance, sex, and obesity severity—particularly for newer GLP-1 receptor agonists. As OM use continues to rise among youth, these gaps may widen without intentional intervention."

Clinical • Real-world • Real-world evidence • Diabetes • Genetic Disorders • Metabolic Disorders • Obesity • Pediatrics

Obesity Medication Use Associated with Greater Use of Clinical Pediatric Obesity Treatment Services (OBESITY WEEK 2025) - "The variable was defined by identifying the prescription of medications approved for treating obesity in adolescents including GLP-1s (i.e., semaglutide and liraglutide), phentermine-topiramate, and orlistat. Findings show obesity medication use was associated with increased clinic visits at a pediatric obesity treatment program. This indicates that youth taking obesity medications are potentially engaging more with obesity treatment and remaining in care, which could have important implications for long-term management of obesity and co-morbidities."

Clinical • Genetic Disorders • Obesity • Pediatrics

Real-World Effectiveness of GLP-1 Receptor Agonists on Clinical Outcomes in Patients with Heart Failure with Preserved Ejection Fraction (HFpEF). (AHA 2025) - "Cox proportional hazards models were used to estimate the relative event hazards for GLP-1 RA users vs. several comparator groups for AOM [bupropion-naltrexone (BN), phentermine-topiramate (PT)] and ADM [DPP4i and SGLT2i].Results/Data: Of 107,252 patients with HFpEF, 68,691 patients (64.0%) were included in the AOM subset [(mean BMI 36.7; 37,962 on GLP1RA (55.3%)], and 38,561 patients (36.0%) met criteria for ADM cohort [12,888 on GLP1RA (33.4%)]... Among patients with HFpEF, the use of GLP-1 RA in the context of obesity treatment was associated with a reduced unadjusted incidence of cardiovascular events, suggesting that efficacy observed in clinical trials may generalize to effectiveness in routine clinical practice."

Clinical • Clinical data • Real-world • Real-world effectiveness • Real-world evidence • Cardiovascular • Congestive Heart Failure • Diabetes • Genetic Disorders • Heart Failure • Metabolic Disorders • Obesity

Glucagon-Like Peptide-1 Receptor Agonist Use Is Associated With Lower Risk Of Cardiovascular Event Recurrence Compared With Use Of Bupropion-Naltrexone or Phentermine-Topiramate: A Nationwide Target Trial Emulation Study (AHA 2025) - "Among patients with CVD, overweight/obesity, and without diabetes mellitus, prescription of GLP-1RA was associated with lower risk of recurrent cardiovascular events compared to approved oral antiobesity therapies."

Atherosclerosis • Cardiovascular • Diabetes • Genetic Disorders • Metabolic Disorders • Myocardial Infarction • Obesity

Semaglutide and Tirzepatide Have the Most Clinical Benefit Compared to Most Weight Loss Medications in Inflammatory Bowel Disease (ACG 2025) - "The study included 6 groups: those on tirzepatide, semaglutide, liraglutide, orlistat, phentermine-topiramate, and naltrexone-bupropion... Tirzepatide and semaglutide showed significant risk reduction in all outcomes. Tirzepatide had the highest risk reduction in steroid use, hospitalization, and mortality compared to all the other agents. Liraglutide had significantly reduced risks in all categories except mortality."

Clinical • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis

Breaking the Cycle: Game-Changing Approaches to Pediatric Obesity Treatment: New-Generation Medications (AACAP 2025) - "In order of efficacy in achieving 10% BMI reduction are semaglutide (63%), phentermine-topiramate (43%), liraglutide (26%), and improvements in cardiometabolic markers. Therefore, assessment, treatment, and monitoring of patients experiencing mental health concerns and dysregulated to disordered eating aligns with a whole-child approach to obesity treatment. When prescribing obesity medications that reduce hunger cues, promoting and tracking adequate nutrition, structured eating, and retention of muscle mass during weight loss, as well as increased activation and mood dysregulation with stimulant therapy, is a recommended safety practice.OBE, ADOL, PSY"

Clinical • Genetic Disorders • Obesity • Pediatrics • Psychiatry • Suicidal Ideation

Phentermine/Topiramate in Adolescents With Type 2 Diabetes and Obesity (clinicaltrials.gov) - P1 | N=13 | Active, not recruiting | Sponsor: University of Minnesota | Trial completion date: Jun 2027 ➔ Oct 2026 | Trial primary completion date: Jun 2026 ➔ Oct 2025

Trial completion date • Trial primary completion date • Diabetes • Genetic Disorders • Metabolic Disorders • Obesity • Pediatrics • Type 2 Diabetes Mellitus

Economic Evaluation of Medications in Prevention and Treatment of Obesity: A Systematic Review. (PubMed, Int J Prev Med) - "Four databases (PubMed, Scopus, Web of Science, and Embase) were searched for full economic evaluations of FDA-approved antiobesity drugs, including semaglutide, liraglutide, tirzepatide, phentermine-topiramate, and orlistat. Semaglutide appears to be a highly effective and economically favorable option, while phentermine-topiramate and orlistat offer practical alternatives in resource-limited settings. Economic evaluations can inform policy decisions and optimize healthcare resource allocation in combating obesity."

HEOR • Journal • Review • Genetic Disorders • Obesity

OBOE-Mayo: Individualized Pharmacological Approach to Obesity in Patients With Bipolar Disorder (clinicaltrials.gov) - P4 | N=100 | Not yet recruiting | Sponsor: Mayo Clinic

New P4 trial • Bipolar Disorder • CNS Disorders • Genetic Disorders • Mood Disorders • Obesity • Psychiatry • Schizophrenia

Safety and Efficacy of Phentermine and Topiramate for Weight Loss in Obesity-Related HFpEF. (PubMed, J Card Fail) - No abstract available

Journal • Cardiovascular • Congestive Heart Failure • Genetic Disorders • Heart Failure • Obesity

A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults. (PubMed, Nat Med) - "Fifty-six clinical trials were identified-orlistat (22), semaglutide (14), liraglutide (11), tirzepatide (6), naltrexone/bupropion (5) and phentermine/topiramate (2)-enrolling 60,307 patients (32,598 OMM and 27,709 placebo)...Tirzepatide was effective in remission of obstructive sleep apnea syndrome and metabolic dysfunction-associated steatohepatitis. These results support the need to individualize the selection of OMMs."

Journal • Retrospective data • Cardiovascular • Congestive Heart Failure • Diabetes • Genetic Disorders • Heart Failure • Hepatology • Immunology • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Musculoskeletal Pain • Obesity • Obstructive Sleep Apnea • Osteoarthritis • Pain • Respiratory Diseases • Rheumatology • Sleep Disorder • Type 2 Diabetes Mellitus

Efficacy and safety of anti-obesity drugs in metabolic dysfunction-associated steatotic liver disease: An updated review. (PubMed, World J Gastroenterol) - "Among these, GLP-1 RAs (e.g., liraglutide and semaglutide) consistently demonstrate hepatic benefits, including reductions in hepatic steatosis, improvements in liver enzyme profiles, and attenuation of fibrosis progression...Retatrutide, a triple agonist, has produced the most pronounced metabolic effects to date, although its impact on liver histology remains underexplored. Other AOMs, such as bupropion-naltrexone and phentermine-topiramate, require cautious use due to potential hepatotoxicity. Importantly, advanced MASLD may alter drug pharmacokinetics, underscoring the need for individualized therapy and close monitoring. This review provides an updated synthesis of the efficacy and safety of current and emerging AOMs in patients with MASLD/MASH and highlights the urgent need for further research to define optimal pharmacological strategies in this high-risk population."

Journal • Review • Fibrosis • Genetic Disorders • Hepatology • Immunology • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Metabolic Dysfunction-Associated Steatotic Liver Disease • Obesity

Pharmacotherapy for Obesity: Recent Updates. (PubMed, Clin Pharmacol) - "We start by focusing on the non-incretin anti-obesity medications orlistat, phentermine, phentermine-topiramate, and naltrexone-bupropion. We also highlight setmelanotide for heritable obesity. The mechanism of action and comparative efficacy of the GLP-1 receptor agonists liraglutide and semaglutide are reviewed...Additional incretin targets in the pipeline include dual co-agonists to glucagon and GLP-1 receptors, triple agonists targeting glucagon, GLP-1 and GIP, novel GLP-1 agonists, oral formulations of GLP-1 agonists, and amylin agonists. Finally, we provide best practices for adjuncts to pharmacologic treatments of obesity, monitoring efficacy of obesity treatments, and adjusting medication regimens for providers."

Journal • Review • Genetic Disorders • Obesity

Comparative Safety of Glucagon-Like Peptide 1 Receptor Agonists (GLP-1-RAs) in Type 2 Diabetes and Chronic Weight Management: A Real-World Data Study. (PubMed, Pharmacoepidemiol Drug Saf) - "This study corroborates an increased risk of hospitalization for gall bladder and biliary conditions among users of GLP-1-RAs and found similar rates as comparators of MI or stroke when GLP-1-RAs were used for T2DM or CWM. This real-world study complements placebo-controlled trials and can further inform prescribing decisions."

Journal • Real-world evidence • Cardiovascular • Diabetes • Hepatology • Liver Failure • Metabolic Disorders • Type 2 Diabetes Mellitus

Anti-obesity Pharmacotherapy and Inflammation (clinicaltrials.gov) - P=N/A | N=30 | Active, not recruiting | Sponsor: Louisiana State University Health Sciences Center in New Orleans | Trial completion date: Jul 2025 ➔ Feb 2026 | Trial primary completion date: Jun 2025 ➔ Jan 2026

Trial completion date • Trial primary completion date • Genetic Disorders • Inflammation • Obesity

OPTIMAL: Optimizing Portal Hypertension With TIPS and Interval Metabolic Surgery for Advanced Liver Disease (clinicaltrials.gov) - P4 | N=70 | Not yet recruiting | Sponsor: The Cleveland Clinic

New P4 trial • Cardiovascular • Fibrosis • Genetic Disorders • Hepatology • Hypertension • Immunology • Liver Cirrhosis • Obesity • Portal Hypertension