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

作者：Kolotkin Ronette L^*; Gadde Kishore M; Peterson Craig A; Cro**y Ross D

来源：Quality of Life Research, 2016, 25(5): 1237-1244.

DOI：10.1007/s11136-015-1153-x

• Health-related quality of life
• Phentermine/topiramate
• Weight loss
• Mediation analysis
• Impact of Weight on Quality of Life-Lite (IWQOL-Lite)
• Short-Form-36 (SF-36)

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, placebo-controlled 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.
Patients in EQUIP (n = 751) had a body mass index (BMI) a parts per thousand yen 35 with no obesity-related comorbidity. Patients in CONQUER (n = 1623) had a BMI a parts per thousand yen 27 and a parts per thousand currency sign 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).
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.
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.

• 出版日期2016-5