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

Abstract Objectives: The objective of this study was to evaluate the effectiveness of the combined use of empagliflozin (EMPA) and topiramate (TPM) versus a placebo in overweight/obese individuals without diabetes on a calorie-restricted diet. Methods: In this study, 44 non-diabetic and overweight/obese subjects who were on a calorie restricted diet were randomly assigned into 2 groups: 1) Participants received a 10 mg EMPA tablet daily plus TPM tablet (at the first week 25 mg once a day and from the second week 25 mg twice a day); 2) Participants received an empagliflozin placebo (daily) plus a topiramate placebo (as mentioned for topiramate tablet in group 1), for 12 weeks. At baseline and weeks 4, 8, 12, weight, height, body mass index (BMI), waist circumference (WC), and body composition were evaluated. Before and after the intervention, blood pressure, C reactive protein, and glucose and lipid profile parameters were measured. Results: The EMPA/TOP group, compared to placebo, had a greater percent change of weight at week 12 (-8.92 ± 1.80 vs. -4.93 ± 1.17). The intervention group had a greater percent change of fat mass and fat percent at week 12 (P<0.05). However, there was no difference in the percent of change in fat-free percent between the two groups at week 12 (P=0.577). Within-group analysis found a significant reduction in SBP, DBP, FBS, insulin, HOMA-IR, TC, LDL, HDL, TG, and CRP in both groups (P<0.05). The Time × Group effect was significant only for DBP (P=0.034). At week 12, no statistically significant difference was observed between the two groups in any of mentioned variables (P>0.05). Conclusion: In non-diabetic overweight/obese individuals, the combination of EMPA/TPM and calorie restriction led to a notable decrease in body weight and was generally well-tolerated. Further research is required to evaluate the potential advantages of utilizing this combination for sustained weight management in the long run. Name of the registry: Iranian Registry of Clinical Trials Trial registration number: IRCT20230114057122N1 Date of registration: 2/1/3/2023 'Retrospectively registered' URL of trial registry record: https://www.irct.ir/trial/68026