Pharmacotherapies for Obesity: Past, Current, and Future Therapies

Table 5

Recent randomised controlled trials of weight loss therapies with 12-month followup.

Drug	No. subjects	Outcomes				Serious adverse events	Reference
		Absolute weight loss (kg) (95% CI)	≥5% weight loss	≥10% weight loss	Change in WC (cm)
Lorcaserin	Placebo-716	2.16±0.14^∧	20.3%	7.7%	3.9±0.2	Headache 2% P, 0.8% L	[120]
	L-883	5.81±0.16𝑃<.001	47.5%𝑃<.001	22.6%𝑃<.001	6.8±0.2 𝑃<.001	Dizziness 0.8% P, 0.1% L
Taranabant	Placebo-417	2.6 (1.8, 3.3)	27.2%	8.4%	−3.1 (2.3, 3.9)	Nausea 6.5% P, 16.7% TB 2 mg, 21.4% TB 4 mg, 𝑃<.001	[31]
	TB 2 mg-415	6.6 (5.9, 7.4), 𝑃<.001	56.5%, 𝑃<.001	27.9%, 𝑃<.001	−7.0 (6.1, 8.1), 𝑃<.001	Vomiting 3.4% P, 8.4 TB 4 mg, 𝑃<.01
	TB 4 mg-414	8.1 (7.4, 8.9), 𝑃<.001	64.2%, 𝑃<.001	35.8%, 𝑃<.001	−7.5 (6.7, 8.3), 𝑃<.001	Diarrhoea 7.2% P, 12.3 TB 2 mg, 𝑃<.05, 13.7% TB 4 mg, 𝑃<.01; Anxiety 3.4 P, 9.9 TB 4 mg, 𝑃<.01
Taranabant	Placebo-196	+1.7 (0.8, 2.7)	62.2%	NR	−0.7 (−0.3, 1.8)	Irritability TB 1 mg and 2 mg, 𝑃≤.038	[116]
	TB 0.5 mg-196	0.1 (−1.0, 0.8), 𝑃<.007	71.8%	NR	−1.5 (−2.6, −0.5)
	TB 1 mg-196	0.6 (−1.5, 0.4), 𝑃<.007	78%, 𝑃<.05	NR	−2.3 (−3.4, −1.3)
	TB 2 mg-196	1.2 (−2.1, −0.3), 𝑃<.007	83.3%, 𝑃<.001	NR	−2.4 (−3.4, −1.3)
Taranabant	Placebo-137	1.4 (−0.5, −2.4)	24.3%	7.3%	−3.0 (−1.9, −4.1)	Psychiatric-17.7% P, 28.8% TB1mg, 29%TB 2 mg, 𝑃≤.038	[118]
	TB 0.5 mg-141	5.0 (−4.0, −5.9), 𝑃<.001	44.2, 𝑃<.001	21.3, 𝑃<.001	−5.6 (−4.5, −6.6), 𝑃<.001
	TB 1 mg-138	5.2 (−4.2, −6.2), 𝑃<.001	45.3, 𝑃<.001	18.2, 𝑃<.001	−5.7 (−4.6, −6.7),𝑃<.001
	TB 2 mg-277	6.4 (−5.7, −7.2), 𝑃<.001	53, 𝑃<.001	28, 𝑃<.001	−6.9 (−6.1, −7.7), 𝑃<.001
Bupropion/naltrexone*	Placebo-202	7.3%±0.9%	60.4%	30.2%	−6.8 (5.3, 8.3)	Nausea 10.5% P, 34.1% BN 𝑃<.001	[121]
	BN 360/32–591	11.5%±0.6%, 𝑃<.001	80.4%, 𝑃<.001	55.2%, 𝑃<.001	−10.0 (9.0, 10.9), 𝑃<.001	Dizziness 4.5% P, 14.6% BN, 𝑃<.001
Bupropion/naltrexone	B-60	2.7±0.9	33%	12%	NA	NA	[22]
	BN 16 mg-64	5.0±0.9	50%	22%
	BN 32 mg-63	6.1±0.8, 𝑃<.05	51%	25%
	BN 48 mg-61	4.6±0.9	39%	20%
Pramlintide	Placebo-63Pramlintide-61	2.1±0.9; 3.6±0.7	3%; 28%	11%; 36%	NR	Nausea 0% P, 30% Pramlintide	[85]
Topiramate	Placebo-55; T−54	2.5±3.1; 6.0±5.2, 𝑃<.001	19%; 50%, 𝑃<.001	2%; 20%, 𝑃<.001	−2.3±4.7; −4.2±5.7, 𝑃=.078	Paraesthesia −0% P, 28% TPsychiatric −11% P, 33% T	[122]
Topiramate/phentermine	P-498	1.6	17%	NA	NA	NA	[123]
	TP 3.75/23 mg-234	5.1, 𝑃<.0001	45%, 𝑃<.0001
	TP15/92 mg-498	11, 𝑃<.0001	67%, 𝑃<.0001
Topiramate/phentermine	P-979	1.8	21%	NA	NA	NA	[123]
	TP 7.5/46 mg-488	8.4, 𝑃<.0001	62%, 𝑃<.0001
	TP15/92 mg-981	10.4, 𝑃<.0001	70%, 𝑃<.0001

Absolute weight loss: weight loss from baseline; NS: not significant, NA: not available; L: lorcaserin; NB: naltrexone/bupropion, TB: taranabant; T: topiramate controlled release; TP: topiramate/phentermine; ^∧mean  ±  standard error; *both groups also received intensive behavior modification.