Combination of Topiramate and Empagliflozin is considered a Good Option for Treatment of Obesity
Abstract
Introduction: The incidence of obesity has risen very much in the latest decades in which more than 30% of peoples are considered obese [1]. It is evidenced that genetics has a great impact on obesity occurrence; all in all, the risk of getting obesity in the future is linked to many factors like sedentary lifestyle, type of diet [4]. Aside from decreasing blood glucose, empagliflozin can lead to a reduction of weight due to the loss of calories by excretion of glucose [17]. Research papers also discuss the weight reducing effect of topiramate and demonstrated that this effect is dependent on the dose of the drug and duration of treatment [24].Objectives: The aim was to show if combination of topiramate and empagliflozine have the greatest weight decreasing effect in comparison to each drug alone and to placebo. Design: Randomised, placebo controlled trial, 6 month trial. Materials and Methods: 200 obese patients were randomized into 4 parallel groups. 4 groups of patients with obesity had been monitored in a private clinic, each group 50 patient’s number, with 35 females and 15 males after written consent from all patients. Result: The results show that both topiramate and empagliflozine have weight loss effect if used alone with significant p value which is 0.0480 with topiramate and 0.0048 in empagliflozine and the greatest weight loss effect if used in combination with p value less than 0.0001.Conclusion: Combination of topiramate and empagliflozin show a considerable reduction of body weight and so is considered as an option for treatment of obesity.
Full Text:
PDFReferences
The epidemiology of obesity Chooi, Yu Chung et al. Metabolism - Clinical and Experimental, Volume 92, 6 - 10.
World Health Organization. Obesity and overweight. Fact sheet no 311 January 2015. ([cited 2016 20 April 2016; Available from]) http://www.who.int/mediacentre/factsheets/fs311/en/
Swinburn, B.A., Sacks, G., Hall, K.D. et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011; 378: 804–814.
Davison KK, Birch LL. Childhood overweight: A contextual model and recommendations for future research. Obes Rev. 2001; 2:159–71.
Anderson PM, Butcher KE. Childhood obesity: Trends and potential causes. Future Child. 2006; 16:19–45.
World Health Organization. Political declaration of the high-level meeting of the general assembly on the prevention and control of non-communicable diseases. WHO
Franco, M. et al. Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends. BMJ 346, f1515 (2013).
Heymsfield, S. B. & Wadden, T. A. Mechanisms, pathophysiology, and management of obesity. N. Engl. J. Med. 376, 254–266 (2017).
Obesity: global epidemiology and pathogenesis. Blüher Matthias. Nature Reviews Endocrinology volume 15, pages288–298 (2019).
Berthoud, H. R., Münzberg, H. & Morrison, C. D. Blaming the brain for obesity: integration of hedonic and homeostatic mechanisms. Gastroenterology 152, 1728–1738 (2017).
Current pharmacotherapy for obesity. Gitanjalis, Caroline M.Nature Reviews Endocrinology volume 14, pages 12–24 (2018).
Evidence-Based Consensus on Positioning of SGLT2i in Type 2 Diabetes Mellitus in Indians. Awadhesh Kumar Singh, Ambika G, et al. Diabetes Ther. 2019 Apr; 10(2): 393–428.Published online 2019 Jan 31.
Glucose handling by the kidney. Amanda Mather, Carol Pollock. Kidney International Volume 79, Supplement 120, March 2011, Pages S1-S6.
Empagliflozin: a new sodium-glucose co-transporter 2 (SGLT2) inhibitor for the treatment of type 2 diabetes. Joshua J Neumiller, Drugs Context. 2014; 3: 212262.Published online 2014 Jun 11.
European Medicines Agency. Jardiance 10 and 25 mg film-coated tablets: summary of product characteristics. 2014. http://www.ema.europa.eu. Accessed 8 June 2018.
Chan HW, Ashan B, Jayasekera P, Collier A, Ghosh S. A new class of drug for the management of type 2 diabetes: sodium glucose co-transporter inhibitors: ‘glucuretics’ Diabetes Metab Syndr. 2012; 6:224–8.
Hach T, Lambers Heerspink HJ, Pfarr E, et al. The sodium glucose cotransporter-2 (SGLT-2) inhibitor empagliflozin lowers blood pressure independent of weight or HbA1c changes. Diabetologia. 2012; 55:S317. Abstract presented at the 48th Annual Meeting of the European Association for the Study of Diabetes, October 1–5, Berlin, Germany.
Hendricks EJ. Off-label drugs for weight management. Diabetes Metab Syndr Obes. 2017; 10:223–234.
Cardiovascular Safety During and After Use of Phentermine and Topiramate. Mary E Ritchey, Abenah Harding, Shannon Hunter, et al.J Clin Endocrinol Metab. 2019 Feb; 104(2): 513–522.Published online 2018 Sep 21.
Antel J, Hebebrand J. Weight-reducing side effects of the antiepileptic agents topiramate and zonisamide. HandbExpPharmacol. 2012; 209:433–66.
Berlant J, van Kammen DP. Open-label topiramate as primary or adjunctive therapy in chronic civilian posttraumatic stress disorder: A preliminary report. J Clin Psychiatry. 2002; 63:15–20.
Claudino AM, de Oliveira IR, Appolinario JC, Cordás TA, Duchesne M, Sichieri R, et al. Double-blind, randomized, placebo-controlled trial of topiramate plus cognitive-behavior therapy in binge-eating disorder. J Clin Psychiatry. 2007; 68:1324–32.
Rosenstock J, Hollander P, Gadde KM, Sun X, Strauss R, Leung A OBD-202 Study Group. A randomized, double-blind, placebo-controlled, multicenter study to assess the efficacy and safety of topiramate controlled release in the treatment of obese type 2 diabetic patients. Diabetes Care. 2007; 30:1480–6.
Impulsiveness as a predictor of topiramate response for cocaine use disorder. Derek Blevins, Xin‐Qun Wang, et al. The American Journal on Addictions, Volume 28, Issue 2.
York, DA, Singer, L, Thomas, S, Bray, GA. Effect of topiramate on body weight and body composition of Osborne‐Mendel rats fed a high‐fat diet: alterations in hormones, neuropeptide, and uncoupling‐protein mRNAs. Nutrition. 2000; 16: 967‐ 975.
Richard, D, Ferland, J, Lalonde, J, et al. Influence of topiramate in the regulation of energy balance. Nutrition. 2000; 16: 961‐ 966.
Greenwood, RS. Adverse effects of antiepileptic drugs. Epilepsia. 2000; 4: S42‐ S51.
A systematic review of reviews: exploring the relationship between obesity, weight loss and health‐related quality of life. R. L. Kolotkin and J. R. Andersen. Clin Obes. 2017 Oct; 7(5): 273–289. Published online 2017 Jul 10.
Organization for Economic Co-operation and Development. Obesity update 2017. OECD https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf (2017).
Panzeri, I. & Pospisilik, J. A. Epigenetic control of variation and stochasticity in metabolic disease. Mol. Metab. 14, 26–38 (2018).
Future Pharmacotherapy for Obesity: New Anti-obesity Drugs on the Horizon. Srivastava, G. & Apovian, C. Curr Obes Rep (2018) 7: 147. https://doi.org/10.1007/s13679-018-0300-4.
Empagliflozin reduces body weight and indices of adipose distribution in patients with type 2 diabetes mellitus. Ian J Neeland, Darren K McGuire. Diab Vasc Dis Res. 2016 Mar; 13(2): 119–126. Published online 2016 Feb 12.doi: 10.1177/1479164115616901.
Wilding J, Van Gaal L, Rissanen A, Vercruysse F, Fitchet M. A randomized double-blind placebo-controlled study of the long-term efficacy and safety of topiramate in the treatment of obese subjects. Int J Obes Relat Metab Disord 2004; 28:1399-1410.
Kumar RB, Aronne LJ. Pharmacologic Treatment of Obesity. [Updated 2017 Aug 7]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279038/.
Refbacks
- There are currently no refbacks.