Table 3.
Author | Inclusion criteria | n | Study design | Predictors of response |
---|---|---|---|---|
ORLISTAT | ||||
Chanoine and Richard71 | Adolescents (12–16 years), BMI ⩾ 2 kg/m2 above the 95th percentile (excluded BMI ⩾ 44 kg/m2; weight > 130 kg of < 55 kg) | Retrospective analysis of a multicenter 1-year RCT (orlistat 120 mg 3 times daily versus placebo); assessed if 3- month weight loss predicted 12-month weight loss | Greater weight loss at 3 months correlated with greater weight loss at 1 year. | |
Elfhag and colleagues72 | Adults, BMI ⩾30 kg/m2 | 148 | Retrospective analysis of self-reported data | Men experienced greater weight loss than women; ‘order’ and ‘deliberation’ facets of conscientiousness positively correlated with weight loss |
Hollywood and Ogden73 | Adults prescribed orlistat | 566 | Retrospective analysis of a 6-month open-label study of participants prescribed orlistat; only those completing baseline and 6-month surveys included in analysis | A decrease in unhealthy eating, increase belief in treatment control, increased belief that the unpleasant side effects of orlistat are both due to eating behavior and just part of the drug, and baseline greater endorsement of medical solutions predicted those most likely to reduce BMI at 6 months |
Rissanen and colleagues74 | Adults, BMI 28–43 kg/m2 | 220 | Retrospective analysis of pooled data from two 2-year multicenter RCTs (orlistat 120 mg 3 times daily versus placebo) comparing those who lost ⩾5% versus <5% weight at 3 months | Weight loss ⩾5% at 3 months predicted sustained weight loss at 2 years |
Toplak and colleagues75 | Adults, BMI 30–43 kg/m2, body weight ⩾90 kg, WC ⩾88 cm (female) or ⩾102 cm (male) | 430 | 1 year, open-label, randomized, parallel group trial with
all participants receiving 120 mg orlistat three times
daily; compared 500 kcal versus 1000 kcal
energy deficit diet; orlistat discontinued in participants who did not achieve ⩾5% weight loss at 3- and 6-month assessment |
⩾5% weight loss at 3 months associated with long-term weight loss at 1 year in both diet groups |
Ullrich and colleagues76 | Adults, BMI 30–40 kg/m2 | 62 | Retrospective analysis of open-label 72 week trial (orlistat 120 mg three times daily versus placebo) | Low fat and carbohydrate intake predicted increased weight loss |
Lorcaserin | ||||
Farr and colleagues90 | Adults, BMI >30 kg/m2 or >27 kg/m2 with ⩾1 comorbidities | 48 | Prospective 1-month RCT comparing lorcaserin 10 mg twice daily with placebo; assessed neuronal activation with fMRI at baseline, 1 week, and 1 month | Activations in amygdala, parietal, and visual cortices at baseline correlated with decreases in caloric intake, weight, and BMI at 1 month |
Smith and colleagues92 | Adults, BMI 30–45 kg/m2 or 27–29.9 kg/m2 with ⩾1 comorbidities | 6897 | Retrospective analysis of pooled data from three trials (BLOOM, BLOSSOM, and BLOOM-DM) comparing lorcaserin + LMT with placebo + LMT; assessed if weight loss response at 3 months predicted response at 1 year | ⩾5% weight loss at 3 months predicted greater weight loss at 1 year |
PHENTERMINE | ||||
Thomas and colleagues93 | Adults, BMI 30–40 kg/m2 | 35 | Prospective 8-week trial of participants receiving phentermine comparing those with ⩾5% versus <5% weight loss | Participants with ⩾5% weight loss had higher pre-breakfast hunger, desire to eat, prospective food consumption and lower baseline cognitive restraint; higher home prospective food consumption and lower baseline cognitive restraint predicted increased weight loss |
Topiramate | ||||
Ben-Menachem and colleagues86 | Adults with epilepsy | 49 | Prospective open-label trial adding topiramate to existing anticonvulsant regimen, assessing change in weight from baseline to 3- and 12-months after topiramate initiated | 3-month weight loss correlated with reduced caloric intake; 1-year weight loss correlated with higher baseline BMI despite caloric intake returning to baseline levels; participants with obesity lost more weight than participants without obesity |
El Yaman and colleagues87 | Children and adults with epilepsy | 120 | Prospective cohort study of participants started on topiramate | Participants with higher baseline BMI and younger age lost more weight at year 2; higher average topiramate dose (>6 mg/kg/day) associated with larger decrease in BMI from baseline |
Iwaki and colleagues88 | Adults with epilepsy | 78 | Prospective, open-label study assessing weight
loss 1, 6, 12, 18 months after starting topiramate; compared those with no versus mild intellectual disability (ID) |
Participants with no/mild ID lost more weight compared with those with moderate/profound ID |
Kazerooni and Lim94 | Adults, BMI ⩾25 kg/m2 | 767 | Retrospective cohort study examining weight loss outcomes 1 year after topiramate initiated (for any indication) | Higher prevalence of females lost ⩾5% compared with
males; adherent participants more likely to lose ⩾5% BW compared with nonadherent participants |
Klein and colleagues89 | Children (⩾12 years) and adults with epilepsy | 22 | Prospective study assessing 3 week, 3 month, 6 month, and long-term weight loss after starting topiramate | Weight loss, reduction of appetite, and amount of intake at 3 months predicted BMI decrease at 6 months; high initial BMI and body fat predicted lower BMI reduction at 6 months |
Li and colleagues91 | Adults, BMI 30–50 kg/m2 or 27–50 kg/m2 with ⩾1 comorbidities | 1004 | Retrospective study of DNA samples from participants previously completing clinical trials, assessing efficacy of topiramate for obesity | Carriers of haplotype T-C-A in INSR had greater weight loss than noncarriers; Rs55834942 SNP from HNF1A associated with increased weight loss response |
Phentermine/topiramate | ||||
Acosta and colleagues95 | Adults, BMI 30–40 kg/m2 | 24 | 2-week RCT assessing effects of phentermine/topiramate on weight and quantitative traits | Higher intake at baseline buffet meal satiety test associated with greater weight loss at 2 weeks |
Naltrexone/bupropion | ||||
Dalton and colleagues96 | Adults, BMI 30–45 kg/m2 or 27–45 kg/m2 with ⩾1 comorbidities | 2,046 | Retrospective analysis of four 56-week RCTs (COR-I, COR-II, COR-BMOD, COR-DM) comparing NB32, NB16, and placebo | Participants with the greatest improvement in craving control at 8 weeks had greater weight loss after 56 weeks |
Fujioka and colleagues97 | Adults, BMI 30–45 kg/m2 or 27–45 kg/m2 with ⩾1 comorbidities | 3362 | Retrospective analysis of four 56-week RCTs (COR-I, COR-II, COR-BMOD, COR-DM) comparing NB32, NB16, and placebo | Participants with ⩾5% weight loss at 4 months more likely to maintain clinically significant weight loss at 1 year |
Liraglutide | ||||
Ard and colleagues77 | Adults, BMI ⩾30 kg/m2 or ⩾27 kg/m2 with ⩾1 comorbidities | 5325 | Retrospective analysis of data from five RCTs (liraglutide 3.0 mg versus placebo) comparing weight loss by race/ethnicity | No significant weight loss response differences by race/ethnicity |
Dahlqvist and colleagues78 | Adults, BMI 27.5–45 kg/m2, HbA1c 7.5–11.5%, c-peptide ⩾10 nmol/l, treated with multiple daily injection insulin for ⩾6 months | 124 | Retrospective analysis of a 24-week RCT comparing liraglutide 1.8 mg with placebo as adjunct to multiple daily injection insulin regimen with or without metformin | Lower HbA1c and mean glucose level predicted greater weight loss response to liraglutide |
Fujioka and colleagues79 | Adults, BMI ⩾30 kg/m2 without DM or BMI ⩾27 kg/m2 with ⩾1 comorbidities not including DM (SCALE Obesity and Prediabetes), or BMI ⩾27 kg/m2 with DM (SCALE Diabetes) | 4577 | Retrospective analysis of data from SCALE Obesity and Prediabetes and SCALE Diabetes trials | Greater proportion of those with ⩾4% weight loss at 4 months achieved ⩾5, ⩾10%, and ⩾15% weight loss at 56 weeks compared with those with <4% weight loss at 4 months |
Gomez-Peralta and colleagues80 | Adults with T2DM on liraglutide | 799 | Retrospective chart review of electronic medical records | Higher baseline weight and longer treatment duration predicted improved weight loss response |
Halawi and colleagues81 | Adults, BMI ⩾ 30 kg/m2 or ⩾27 kg/m2 with ⩾1 comorbidities | 40 | Prospective 4-month RCT assessing effect of liraglutide versus placebo on gastric motor function, satiety, and weight | Delayed gastric emptying at 5 weeks correlated with increased weight loss with liraglutide at 4 months |
Wilding and colleagues82 | Adults, BMI ⩾30 kg/m2 without DM or BMI ⩾27 kg/m2 with ⩾1 comorbidities not including DM (SCALE Obesity and Prediabetes), or BMI ⩾ 27 kg/m2 with DM (SCALE Diabetes) | 4372 | Retrospective analysis of data from SCALE Obesity and Prediabetes and SCALE Diabetes trials | Increased drug exposure correlated with increased weight loss |
EXENATIDE | ||||
Anichini and colleagues83 | Adults with T2DM and therapeutic failure on oral therapy (metformin or metformin + SU) | 315 | Retrospective analysis of participants prescribed exenatide 10 µg twice daily | Longer DM duration in males, lower baseline A1c in females predicted those most likely to lose ⩾8.5% weight at 1 year |
Gorgojo-Martínez and colleagues84 | Adults, T2DM, BMI ⩾ 30 kg/m2 | 148 | Retrospective analysis of participants prescribed exenatide 2 mg weekly | Higher BMI, previous use of DPP4 inhibitors predicted weight loss ⩾3% after 6 months |
Nathan and colleagues85 | Children (12–19 years), BMI ⩾1.2 times 95th percentile or BMI ⩾35 kg/m2, without DM | 32 | Retrospective analysis of 2 RCTs comparing exenatide 10 µg twice daily versus placebo | Higher baseline appetite, female sex predicted greater BMI loss at 3 months |
BMI, body mass index; DM, diabetes mellitus; DPP4, dipeptidyl peptidase-4; fMRI, functional magnetic resonance imaging; HbA1c, hemoglobin A1c; HNF1A, hepatocyte nuclear factors 1-alpha; INSR, insulin receptor; LMT, lifestyle modification therapy; NB16, 16 mg naltrexone SR/360 mg bupropion SR; NB32, 32 mg naltrexone SR/360 mg bupropion SR; RCT, randomized controlled trial; SCALE, Satiety and Clinical Adiposity Liraglutide Evidence; SNP, single nucleotide polymorphism; SU, sulfonylureas; T2DM, type 2 diabetes mellitus; WC, waist circumference.