Empagliflozin and Topiramate combo Effective for Weight Loss in Non-Diabetic Overweight Individuals: Study

"Additional research is needed to assess the long-term benefits of this combination for effective and sustained weight management," Majid Valizadeh, Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran, and colleagues wrote in Eating and Weight Disorders.

The study explored the effectiveness of combining empagliflozin, an SGLT2 inhibitor, and topiramate, an anticonvulsant commonly used for weight loss, compared to a placebo in overweight or obese individuals without diabetes who are following a calorie-restricted diet.

In this study, 44 non-diabetic individuals with overweight or obesity who were following a calorie-restricted diet were randomly divided into two groups: (1) one group received a daily 10 mg empagliflozin (EMPA) tablet along with topiramate (TPM), starting with 25 mg once daily in the first week and increasing to 25 mg twice daily from the second week; (2) the other group received daily placebos for both empagliflozin and topiramate, following the same schedule as the active treatment, for 12 weeks.

Evaluations for weight, height, body mass index (BMI), waist circumference (WC), and body composition were conducted at baseline and weeks 4, 8, and 12. Additionally, blood pressure, C-reactive protein, and parameters related to glucose and lipid profiles were measured before and after the intervention.

The following were the key findings of the study:

• The EMPA/TPM group experienced a greater percentage decrease in weight at week 12 compared to the placebo group (−8.92 ± 1.80 vs. −4.93 ± 1.17). This intervention group also showed a more significant reduction in fat mass and fat percentage.
• There was no notable difference in the change in fat-free percentage between the two groups at week 12.
• Within each group, there was a significant decrease in systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), insulin levels, HOMA-IR, total cholesterol (TC), LDL, HDL, triglycerides (TG), and C-reactive protein (CRP).
• Despite these changes, no statistically significant differences were found between the two groups for any of these variables at week 12.

The findings showed that the 12-week administration of EMPA/TPM along with calorie restriction in overweight, non-diabetic patients resulted in a notable decrease in body weight, BMI, and fat mass, with participants generally tolerating the treatment well. However, there were no significant changes in waist circumference, glycemic and lipid profiles, blood pressure, or inflammation between the two groups.

Reference:

Abiri, B., Ramezani Ahmadi, A., Hosseinpanah, F. et al. Randomized study of the effects of empagliflozin and topiramate dual therapy on anthropometric and metabolic indices in non-diabetic individuals with overweight/obesity on a calorie-restricted diet. Eat Weight Disord 29, 64 (2024). https://doi.org/10.1007/s40519-024-01692-2