Phentermine/Topiramate: Pediatric First Approval

Paediatr Drugs. 2022 Nov;24(6):715-720. doi: 10.1007/s40272-022-00532-z.

Abstract

Phentermine/topiramate extended-release capsule (Qsymia®) is a fixed-dose combination of phentermine and topiramate, which is being developed by VIVUS (a subsidiary of Icahn Enterprises) for the treatment of obesity, sleep apnoea syndrome, type 2 diabetes mellitus and non-alcoholic steatohepatitis (NASH). The once-daily formulation of phentermine (a sympathomimetic amine) and topiramate is designed to combat obesity by decreasing appetite and increasing satiety. In July 2022, phentermine/topiramate received its first approval in the USA, as an adjunct to a reduced-calorie diet and increased physical activity, for chronic weight management in pediatric patients aged ≥ 12 years with BMI in the 95th percentile or greater standardized for age and sex. Phentermine/topiramate is approved in the US and South Korea for obesity in adults. Clinical development of phentermine/topiramate for sleep apnoea syndrome and type-2 diabetes in obese patients and preclinical development for NASH is ongoing in the US. This article summarizes the milestones in the development of phentermine/topiramate leading to this pediatric first approval for chronic weight management in adolescents.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Anti-Obesity Agents* / adverse effects
  • Child
  • Delayed-Action Preparations
  • Diabetes Mellitus, Type 2* / drug therapy
  • Fructose / therapeutic use
  • Humans
  • Non-alcoholic Fatty Liver Disease*
  • Obesity / complications
  • Obesity / drug therapy
  • Phentermine / adverse effects
  • Sleep Apnea Syndromes* / drug therapy
  • Sympathomimetics / therapeutic use
  • Topiramate / therapeutic use
  • Weight Loss

Substances

  • Topiramate
  • Anti-Obesity Agents
  • Sympathomimetics
  • Delayed-Action Preparations
  • Phentermine
  • Fructose