Trial Outcomes & Findings for Peripheral Pharmacodynamics of Phentermine-Topiramate in Obese Patients (NCT NCT01834404)

NCT ID: NCT01834404

Last Updated: 2015-02-23

Results Overview

Gastric emptying of solids half-time is defined as the time for half of the ingested solids to leave the stomach. At visit 6 subjects took part in a gastric emptying by scintigraphy test. Subjects were given a scrambled egg breakfast with toast and a glass of milk. The eggs and milk contained a small amount of radioactive substance. At the completion of the meal, subjects stood in front of a special camera and pictures were taken at specific intervals.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

24 participants

Primary outcome timeframe

Day 15, approximately 2 hours after radiolabeled meal was ingested

Results posted on

2015-02-23

Participant Flow

Subjects were recruited from patients attending the Mayo Clinic in Rochester, Minnesota.

Participant milestones

Participant milestones
Measure
Phentermine-Topiramate ER
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Overall Study
STARTED
12
12
Overall Study
COMPLETED
12
12
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Peripheral Pharmacodynamics of Phentermine-Topiramate in Obese Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Total
n=24 Participants
Total of all reporting groups
Age, Continuous
31.8 years
STANDARD_DEVIATION 1.8 • n=99 Participants
38.2 years
STANDARD_DEVIATION 2.4 • n=107 Participants
34.8 years
STANDARD_DEVIATION 7.4 • n=206 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
2 Participants
n=107 Participants
4 Participants
n=206 Participants
Sex: Female, Male
Male
10 Participants
n=99 Participants
10 Participants
n=107 Participants
20 Participants
n=206 Participants
Region of Enrollment
United States
12 participants
n=99 Participants
12 participants
n=107 Participants
24 participants
n=206 Participants
Body Mass Index (BMI)
35.8 kg/m^2
STANDARD_DEVIATION 0.9 • n=99 Participants
33.9 kg/m^2
STANDARD_DEVIATION 1.9 • n=107 Participants
34.9 kg/m^2
STANDARD_DEVIATION 5.1 • n=206 Participants
Waist Circumference
108.5 cm
STANDARD_DEVIATION 2.2 • n=99 Participants
111.2 cm
STANDARD_DEVIATION 2.2 • n=107 Participants
109.8 cm
STANDARD_DEVIATION 7.5 • n=206 Participants
Fasting Plasma Glucose
94.2 mg/dL
STANDARD_DEVIATION 2.7 • n=99 Participants
96.5 mg/dL
STANDARD_DEVIATION 3.6 • n=107 Participants
95.3 mg/dL
STANDARD_DEVIATION 10.6 • n=206 Participants
Baseline Volume to Fullness
712 ml
STANDARD_DEVIATION 86 • n=99 Participants
710 ml
STANDARD_DEVIATION 95 • n=107 Participants
711.3 ml
STANDARD_DEVIATION 306.3 • n=206 Participants
Baseline Maximum Tolerated Volume
1368 ml
STANDARD_DEVIATION 111 • n=99 Participants
1227 ml
STANDARD_DEVIATION 111 • n=107 Participants
1297.8 ml
STANDARD_DEVIATION 383.2 • n=206 Participants

PRIMARY outcome

Timeframe: Day 15, approximately 2 hours after radiolabeled meal was ingested

Gastric emptying of solids half-time is defined as the time for half of the ingested solids to leave the stomach. At visit 6 subjects took part in a gastric emptying by scintigraphy test. Subjects were given a scrambled egg breakfast with toast and a glass of milk. The eggs and milk contained a small amount of radioactive substance. At the completion of the meal, subjects stood in front of a special camera and pictures were taken at specific intervals.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Gastric Emptying of Solids Half-Time (T 1/2)
109 minutes
Standard Error 7
88 minutes
Standard Error 7

PRIMARY outcome

Timeframe: Day 13, approximately 10 minutes after Technetium (99mTC) injection

Fasting whole gastric volume was measured by Technetium (99mTc)-SPECT Imaging. Subjects reported to the clinic after an overnight fast. 99mTC was given by an intravenous injection in the forearm. Tomographic images of the gastric wall were obtained throughout the long axis of the stomach using a dual-head gamma camera that rotates around the body. This allows assessment of the radiolabeled circumference of the gastric wall, rather than the intragastric content.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Fasting Gastric Volume
227 mL
Standard Error 25
261 mL
Standard Error 25

PRIMARY outcome

Timeframe: Day 13, approximately 30 minutes after liquid meal

Postprandial gastric volume was measured by 99mTc-SPECT Imaging. Subjects reported to the clinic after an overnight fast. 99mTC was given by an intravenous injection in the forearm. After the liquid meal tomographic images of the gastric wall were obtained throughout the long axis of the stomach using a dual-head gamma camera that rotates around the body. This allows assessment of the radiolabeled circumference of the gastric wall, rather than the intragastric content.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Postprandial Gastric Volume
680 mL
Standard Error 37
681 mL
Standard Error 37

PRIMARY outcome

Timeframe: Day 14, approximately 30 minutes after liquid meal

At visit 5, subjects did a satiation/nutrient drink test. Participants recorded their sensations every 5 minutes using a numerical scale from 0-5, with level 0 being no symptoms, level 3 corresponding to fullness sensation after a typical meal, and level 5 corresponding to the maximal tolerated volume (maximum or unbearable fullness/satiation). This measure was the volume consumed when the fullness sensation reached level 3.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Volume to Fullness
570 mL
Standard Error 63.2
630 mL
Standard Error 61.1

PRIMARY outcome

Timeframe: Day 14, approximately 30 minutes after liquid meal

At visit 5, subjects did a satiation/nutrient drink test. Participants recorded their sensations every 5 minutes using a numerical scale from 0-5, with level 0 being no symptoms, level 3 corresponding to fullness sensation after a typical meal, and level 5 corresponding to the maximal tolerated volume (maximum or unbearable fullness/satiation). This measure is the volume consumed when the fullness sensation reached level 5.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Maximum Tolerated Volume
966 mL
Standard Error 79
1108 mL
Standard Error 79

PRIMARY outcome

Timeframe: Day 13, approximately 4.5 hours after liquid meal

At visit 4 subjects underwent imaging to measure the volume of their stomach, fasting and after ingesting a liquid nutrient drink. Four hours after the liquid meal, subjects were invited to eat, over a 30-minute period, a standard "all you can eat" meal vegetable lasagna, vanilla pudding, and skim milk. The total Kcal of the food consumed was analyzed by using validated software.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Buffet Meal Intake
728 Kcal
Standard Error 79
988 Kcal
Standard Error 79

SECONDARY outcome

Timeframe: Day 15, approximately 2 hours after radiolabeled meal was ingested

At visit 6 subjects took part in a gastric emptying by scintigraphy test. Subjects were given a scrambled egg breakfast with toast and a glass of milk. The eggs and milk contained a small amount of radioactive substance. At the completion of the meal, subjects stood in front of a special camera and pictures were taken at specific intervals. This outcome measure is the proportion of the radiolabeled meal emptied at 2 hours.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Solid Gastric Emptying: Proportion of Meal Emptied at 2 Hours
0.56 proportion of meal emptied
Standard Error 0.03
0.66 proportion of meal emptied
Standard Error 0.03

SECONDARY outcome

Timeframe: Day 15, approximately 4 hours after radiolabeled meal was ingested

At visit 6 subjects took part in a gastric emptying by scintigraphy test. Subjects were given a scrambled egg breakfast with toast and a glass of milk. The eggs and milk contained a small amount of radioactive substance. At the completion of the meal, subjects stood in front of a special camera and pictures were taken at specific intervals. This outcome measure is the proportion of the radiolabeled meal remaining at 4 hours.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Solid Gastric Emptying: Proportion Remaining at 4 Hours
0.09 proportion of meal remaining
Standard Error 0.02
0.16 proportion of meal remaining
Standard Error 0.02

SECONDARY outcome

Timeframe: Day 13, approximately approximately 30 min after liquid meal

Change between postprandial and fasting whole gastric volume by 99mTc-SPECT Imaging. A noninvasive SPECT method was used to measure gastric volume during fasting and 32 min after a liquid nutritional supplement meal. Subjects reported to the clinic after an overnight fast. 99mTC was given by an intravenous injection in the forearm. The first fasting scan was obtained, and the study medication was given s.c. After 10 min, a 2nd fasting post medication scan was obtained, and the meal consumed; then two serial postprandial scans were obtained. Each scan required 9-12 min. Tomographic images of the gastric wall were obtained throughout the long axis of the stomach using a dual-head gamma camera that rotates around the body. This allows assessment of the radiolabeled circumference of the gastric wall, rather than the intragastric content.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Change in Postprandial Gastric Volume
453 mL
Standard Error 24
420 mL
Standard Error 24

SECONDARY outcome

Timeframe: Day 14, before liquid meal

Plasma gastrointestinal hormone total ghrelin was measured by radioimmunoassay.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Fasting Ghrelin
78.1 pg/mL
Standard Error 5.6
82.6 pg/mL
Standard Error 10.8

SECONDARY outcome

Timeframe: Day 14, approximately 45 minutes after liquid meal

Plasma gastrointestinal hormone CCK was measured by radioimmunoassay based on an antibody with very low cross-reactivity to gastrin 17 and its sulfated counterpart, and to sensitivity to a concentration of 0.3 pmol/L.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Peak Postprandial Level of Cholecystokinin (CCK)
8.1 pg/mL
Standard Error 0.9
8.3 pg/mL
Standard Error 1

SECONDARY outcome

Timeframe: Day 14, approximately 45 minutes after liquid meal

Plasma gastrointestinal hormone GLP-1 was measured by radioimmunoassay.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Peak Postprandial Level of Total Glucagon-Like Peptide-1 (GLP-1)
13.0 pg/mL
Standard Error 1.8
11.9 pg/mL
Standard Error 1.6

SECONDARY outcome

Timeframe: Day 14, approximately 45 minutes after liquid meal

Plasma gastrointestinal hormone PYY was measured by radioimmunoassay.

Outcome measures

Outcome measures
Measure
Phentermine-Topiramate ER
n=12 Participants
Qualifying participants were assigned to the Phentermine-Topiramate ER for a minimum of 5 days. The dosing of the study drug was phentermine 3.75 mg / topiramate 23 mg days 1-5. The dosing of the study drug was increased to phentermine 7.5 mg / topiramate 46 mg days 6-14.
Placebo
n=12 Participants
Qualifying participants were assigned to placebo for a minimum of 5 days. Placebo pills matched the study drug in appearance for the 2 dose levels.
Peak Postprandial Level of Total Peptide Tyrosine-Tyrosine (PYY)
195.3 pg/mL
Standard Error 21.2
166 pg/mL
Standard Error 15.7

Adverse Events

Phentermine-Topiramate ER

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Michael Camilleri

Mayo Clinic

Phone: 507-284-6218

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place