title: Topiramate-Associated Weight Loss in a Veteran Population.
abstract: OBJECTIVE
  This study aims to see whether patients in a real-world setting taking topiramate for varied indications experience significant weight loss.
  
  
  METHODS
  This was a retrospective cohort study from the Veterans Affairs San Diego Healthcare System. Patients were new topiramate users between January 1, 2000 and December 31, 2013 with body mass index > 25 kg/m(2) and medication possession ratio > 0.5. Primary outcome determined if topiramate users experienced significant changes in weight and body mass index. Secondary outcome analyzed predictive factors associated with 5% weight loss using logistic regression models. Patients were followed up 1 year post index date.
  
  
  RESULTS
  A total of 767 patients were included in the final analysis. Patients lost an average of 5.6 lbs (216.1 lbs preweight vs. 210.5 lbs postweight) at an average follow-up of 7.8 months. A total of 43.2% (92/213) of females lost 5% of their body weight compared to 29.4% (163/554) of males. Females (odds ratio 1.73; 95% confidence interval 1.21-2.48; p = 0.003), topiramate indication other than headache, and adherent patients (odds ratio 1.78; 95% confidence interval 1.28-2.49; p = 0.001) were more likely to lose 5% of body weight.
  
  
  CONCLUSIONS
  Topiramate should be considered with higher priority in overweight and obese patients for nonweight loss indications for dual benefit.
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, CA.
authors.forename: Rashid
authors.initials: R
authors.lastname: Kazerooni
authors.affiliation: Veterans Affairs San Diego Healthcare System, San Diego, CA.
authors.forename: Jane
authors.initials: J
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000191:economics / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use*; D015992:Body Mass Index; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D012189:Retrospective Studies; D000077236:Topiramate; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D019440:Anti-Obesity Agents; D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose