Children in the Forest

Qsymia Adds to the Possibilities for Teens with Obesity

At the Pediatric Endocrine Society annual meeting this weekend came some good news. Pediatric obesity care providers may soon have one more option for treating teens with obesity. In a well-controlled study of Qsymia for treating obesity in teens, Aaron Kelly reported impressive results.

He and his colleagues tested two doses – a mid-range and a top dose. The mid dose was 7.5 mg of phentermine and 46 mg of topiramate. The top dose was 15 and 92. At that top dose, teens lost ten percent more weight than they did in the control group.

This may not sound like a lot when we’re reading about bigger numbers for adults with even newer drugs. But it’s a big step forward for youth who have had little to help them with obesity other than diet and exercise programs which often yield little success.

Full Results in NEJM Evidence

Kelly et al have just published their full results in NEJM Evidence.

It’s worthwhile to compare these results to the BMI reduction named as a benchmark for meaningful results in a systematic review for the Endocrine Society pediatric guidelines. That review concluded that a reduction of 1.6 kg/m² is clinically meaningful. For the mid dose in this study, the outcome was twice as good as that benchmark. For the top dose, it was three times better.

Yes, these are impressive results.

The Importance of Having More Tools

Obesity can be wickedly hard to treat for the teens affected. So pediatric medicine physician Valerie O’Hara tell us:

“This is very important. I have been prescribing these two drugs individually and have found that some patients have a good response. If we can add yet another anti-obesity medicine to our tools, then these kids will benefit!

“But now the challenge genomes getting payers to cover these medicines.”

Qsymia has not been a blockbuster, in part because it carries a relatively low price. So with limited prescribing it did not generate the sales that much more expensive drugs did.

But this is an important step forward for kids who have few options to help them overcome obesity. We look forward to the possibility that it will lead to Qsymia becoming another FDA-approved option for obesity in teens.

Click here for the new study by Kelly et al and here for perspective on patterns of prescribing for anti-obesity medicines in pediatric patients. For a systematic review of weight loss and cardiometabolic outcomes in children, click here.

Children in the Forest, painting by Ivan Kramskoy / WikiArt

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May 2, 2022