Journal Article

Health-related quality of life in two randomized controlled trials of phentermine/topiramate for obesity: What mediates improvement?

Peterson, Craig A., Kolotkin, Ronette L., Crosby, Ross D., Gadde, Kishore M.

2016

Overview

Purpose Phentermine/topiramate combination therapy resulted in significant weight loss and improvements in cardiometabolic risk factors in patients with obesity/overweight in two published 56-week randomized, placebocontrolled trials (EQUIP and CONQUER). The purpose of the current study was to examine whether phentermine/topiramate is also associated with greater improvements in health-related quality of life (HRQOL) and whether HRQOL improvements are solely attributable to weight reduction. Methods Patients in EQUIP (n = 751) had a body mass index (BMI) ≥ 35 with no obesity-related comorbidity. Patients in CONQUER (n = 1623) had a BMI ≥ 27 and ≤ 45 and at least two obesity-related comorbid conditions. HRQOL was assessed with Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and Medical Outcomes Study Short Form (SF-36) (CONQUER only). Results Significant improvements in both obesity-specific and physical HRQOL were observed at 56 weeks in both trials (p < .0001). In EQUIP, BMI reduction fully mediated improvements in IWQOL-Lite total score (p < .0001). In CONQUER, both BMI reduction (all p values <.0001) and change in depressive symptoms (all p values <.025) were significant mediators of improved IWQOL-Lite total score and SF-36 Physical Component Summary score. Gender, psychiatric history, and baseline triglycerides moderated these relationships. Conclusions Both trials demonstrated that treatment with phentermine/topiramate improved HRQOL compared with placebo. Although reduction in BMI accounted for the majority of improvements in obesity-specific and physical HRQOL, decrease in depressive symptoms was also a significant mediator. Results highlight the predominance of weight reduction as a key factor in improving HRQOL in obesity.

• Publisher: Springer,Springer International Publishing,Springer Nature B.V
• Subject: Adult / Antihypertensives / Blood pressure / Body Mass Index / Body Weight / CLINICAL AND POLICY APPLICATIONS / Clinical trials / Comorbidity / Depression - drug therapy / Depressive disorders / Female / Fructose - analogs & derivatives / Fructose - therapeutic use / Glucose / Health Status / Health surveys / Humans / Male / Mediation / Mediators / Medicine / Medicine & Public Health / Mental depression / Middle Aged / Obesity / Obesity - drug therapy / Obesity - psychology / Outcome Assessment (Health Care) / Overweight / Patients / Phentermine - therapeutic use / Placebos / Prescription drugs / Psychiatry / Public Health / Quality of Life / Quality of Life Research / Questionnaires / Randomized Controlled Trials as Topic / Sociology / Surveys and Questionnaires / Triglycerides / Type 2 diabetes mellitus / Weight control / Weight loss / Weight Loss - drug effects