Medications After Adolescent Bariatric Surgery

NCT ID: NCT04572217

Last Updated: 2025-05-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE2

Study Classification

INTERVENTIONAL

Study Start Date

2022-06-01

Study Completion Date

2022-06-01

Brief Summary

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This study will assess the feasibility to assess practicality of early weight loss medication usage in adolescent patients post-VSG with inadequate weight loss. Participants who enroll in the study will be prescribed off-label use of weight loss medications for a period of up to 1 year.

Detailed Description

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Conditions

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Pediatric Obesity

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Pilot feasibility study
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Medication Group

Adolescent patients post vertical sleeve gastrectomy who have had inadequate weight loss, who consented for use of off-label medications prescribed at the discretion (one or both) of physician.

Patients will be followed every 2-12 weeks over one year.

All patients in this group will continue to follow the standard of care procedures of our multidisciplinary bariatric clinic, including frequent follow-up appointments, nutrition guidance, vitamin supplementation, exercise instruction, and healthy lifestyle education.

Group Type EXPERIMENTAL

Topiramate

Intervention Type DRUG

Topiramate (starting dose 25 mg daily, max dose 100 mg daily)

Phentermine

Intervention Type DRUG

Phentermine (starting dose 8 mg, max dose 16 mg)

Non-Medication Group

Adolescent patients post vertical sleeve gastrectomy who had inadequate weight loss and did not consent for use of off-label medications.

All patients in this group will continue to follow the standard of care procedures of our multidisciplinary bariatric clinic, including frequent follow-up appointments, nutrition guidance, vitamin supplementation, exercise instruction, and healthy lifestyle education.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Topiramate

Topiramate (starting dose 25 mg daily, max dose 100 mg daily)

Intervention Type DRUG

Phentermine

Phentermine (starting dose 8 mg, max dose 16 mg)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Surgical patients in the LPCH/Stanford bariatric and weight management clinics
* Inadequate weight loss after vertical sleeve gastrectomy

Exclusion Criteria

* Adequate weight loss after surgery;
* Unwilling to consent or adhere to safety monitoring plan;
* Any life-threatening or terminal diseases
* Currently pregnant, breastfeeding, or thinking of becoming pregnant
* Allergy or medical contraindication to phentermine or topiramate;
* History of drug or alcohol abuse;
* No known medication interactions;
* Significant renal or hepatic impairment;
* Participation in a study of an investigational medication 30 days prior to screening, while the patient is on study, and for 30 days after their last dose of study treatment
Minimum Eligible Age

12 Years

Maximum Eligible Age

25 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Maternal and Child Health Research Institute

UNKNOWN

Sponsor Role collaborator

Janey Pratt

OTHER

Sponsor Role lead

Responsible Party

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Janey Pratt

Clinical Associate Professor of Surgery

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Janey Pratt, MD

Role: PRINCIPAL_INVESTIGATOR

Stanford University

Locations

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Stanford University

Palo Alto, California, United States

Site Status

Countries

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United States

References

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Aldenkamp AP, Baker G, Mulder OG, Chadwick D, Cooper P, Doelman J, Duncan R, Gassmann-Mayer C, de Haan GJ, Hughson C, Hulsman J, Overweg J, Pledger G, Rentmeester TW, Riaz H, Wroe S. A multicenter, randomized clinical study to evaluate the effect on cognitive function of topiramate compared with valproate as add-on therapy to carbamazepine in patients with partial-onset seizures. Epilepsia. 2000 Sep;41(9):1167-78. doi: 10.1111/j.1528-1157.2000.tb00322.x.

Reference Type BACKGROUND
PMID: 10999556 (View on PubMed)

Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005 Mar 17;352(11):1112-20. doi: 10.1056/NEJMra041867. No abstract available.

Reference Type BACKGROUND
PMID: 15784664 (View on PubMed)

Chanoine JP, Richard M. Early weight loss and outcome at one year in obese adolescents treated with orlistat or placebo. Int J Pediatr Obes. 2011 Apr;6(2):95-101. doi: 10.3109/17477166.2010.519387. Epub 2010 Sep 22.

Reference Type BACKGROUND
PMID: 20858149 (View on PubMed)

Czepiel KS, Perez NP, Campoverde Reyes KJ, Sabharwal S, Stanford FC. Pharmacotherapy for the Treatment of Overweight and Obesity in Children, Adolescents, and Young Adults in a Large Health System in the US. Front Endocrinol (Lausanne). 2020 May 13;11:290. doi: 10.3389/fendo.2020.00290. eCollection 2020.

Reference Type BACKGROUND
PMID: 32477270 (View on PubMed)

Doose DR, Wang SS, Padmanabhan M, Schwabe S, Jacobs D, Bialer M. Effect of topiramate or carbamazepine on the pharmacokinetics of an oral contraceptive containing norethindrone and ethinyl estradiol in healthy obese and nonobese female subjects. Epilepsia. 2003 Apr;44(4):540-9. doi: 10.1046/j.1528-1157.2003.55602.x.

Reference Type BACKGROUND
PMID: 12681003 (View on PubMed)

Hendricks EJ, Srisurapanont M, Schmidt SL, Haggard M, Souter S, Mitchell CL, De Marco DG, Hendricks MJ, Istratiy Y, Greenway FL. Addiction potential of phentermine prescribed during long-term treatment of obesity. Int J Obes (Lond). 2014 Feb;38(2):292-8. doi: 10.1038/ijo.2013.74. Epub 2013 May 17.

Reference Type BACKGROUND
PMID: 23736363 (View on PubMed)

Kramer CK, Leitao CB, Pinto LC, Canani LH, Azevedo MJ, Gross JL. Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials. Obes Rev. 2011 May;12(5):e338-47. doi: 10.1111/j.1467-789X.2010.00846.x. Epub 2011 Mar 28.

Reference Type BACKGROUND
PMID: 21438989 (View on PubMed)

Lewis KH, Fischer H, Ard J, Barton L, Bessesen DH, Daley MF, Desai J, Fitzpatrick SL, Horberg M, Koebnick C, Oshiro C, Yamamoto A, Young DR, Arterburn DE. Safety and Effectiveness of Longer-Term Phentermine Use: Clinical Outcomes from an Electronic Health Record Cohort. Obesity (Silver Spring). 2019 Apr;27(4):591-602. doi: 10.1002/oby.22430.

Reference Type BACKGROUND
PMID: 30900410 (View on PubMed)

Ahamada Safna Mariyam M, Sen S, Vijayan K. Topiramate: Safety in migraine patients. J Young Pharm. 2013 Mar;5(1):30-1. doi: 10.1016/j.jyp.2012.12.001. Epub 2013 Mar 6. No abstract available.

Reference Type BACKGROUND
PMID: 24023450 (View on PubMed)

Martin R, Kuzniecky R, Ho S, Hetherington H, Pan J, Sinclair K, Gilliam F, Faught E. Cognitive effects of topiramate, gabapentin, and lamotrigine in healthy young adults. Neurology. 1999 Jan 15;52(2):321-7. doi: 10.1212/wnl.52.2.321.

Reference Type BACKGROUND
PMID: 9932951 (View on PubMed)

Rich S, Rubin L, Walker AM, Schneeweiss S, Abenhaim L. Anorexigens and pulmonary hypertension in the United States: results from the surveillance of North American pulmonary hypertension. Chest. 2000 Mar;117(3):870-4. doi: 10.1378/chest.117.3.870.

Reference Type BACKGROUND
PMID: 10713017 (View on PubMed)

Rissanen A, Lean M, Rossner S, Segal KR, Sjostrom L. Predictive value of early weight loss in obesity management with orlistat: an evidence-based assessment of prescribing guidelines. Int J Obes Relat Metab Disord. 2003 Jan;27(1):103-9. doi: 10.1038/sj.ijo.0802165.

Reference Type BACKGROUND
PMID: 12532161 (View on PubMed)

Other Identifiers

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1092951-100- KHAAX

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

54967

Identifier Type: -

Identifier Source: org_study_id

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