Patients with prediabetes and/or metabolic syndrome demonstrated significant weight loss and a markedly reduced progression to type 2 diabetes after 2 years of treatment with phentermine-topiramate extended-release plus lifestyle modifications, according to data published in Diabetes Care.

The medically assisted weight-loss intervention was highly effective in preventing diabetes among high-risk patients by 78.7%, W. Timothy Garvey, MD, chairman of the department of nutrition sciences at the University of Alabama at Birmingham, told Endocrine Today.

“If we can prevent 80% of diabetes in America, we’d go a long way toward reducing health care costs and the burden of diabetes on patients and the suffering that it causes,” Garvey said.

The researchers conducted SEQUEL, a subanalysis of the phase 3, randomized, placebo-controlled, double blind CONQUER trial, consisting of overweight or obese patients (BMI ≥27 to ≤45) with more than two comorbidities, according to data.

Patients with prediabetes (n=292) and metabolic syndrome (n=451) were included in the subanalysis.

After 108 weeks of random assignment to either placebo or phentermine-topiramate (Qsymia, Vivus), the cohort lost 10.9% of their body weight in the phentermine-topiramate 7.5-mg/46-mg treatment arm and 12.1% of their body weight in the 15-mg/92-mg treatment arm (P<.0001), compared with 2.5% in the placebo group.

There also was a 70.5% decreased annual incidence rate of type 2 diabetes for those assigned to 7.5 mg/46 mg and 78.7% for those assigned to 15 mg/92 mg (P<.05), compared with placebo.

“Here, we have two diagnostic codes for prediabetes and metabolic syndrome; you identity those patients, you know they have high risk for diabetes and cardiovascular disease and risk factors,” Garvey said. “These can be improved with weight loss. In this case, medicine-assisted weight loss particularly yielded up to 10% or more loss of body weight.” – by Samantha Costa