Zonisamide for Weight Reduction in Obese Adults

Overview

The primary aim of this study is to assess long-term weight loss efficacy of zonisamide relative to placebo in obese patients prescribed a dietary intervention.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: September 2011

Detailed Description

This RCT compares two doses of zonisamide and placebo for one year. A total of 225 subjects are randomly assigned to one of the three treatment interventions at Duke University Medical Centre. The primary outcome measure is change in body weight in kilograms. Secondary outcomes include changes in waist circumference, glycaemic and inflammatory markers, lipids, food craving, hunger and satiety, quality of life, blood pressure and heart rate.

Interventions

  • Drug: Zonisamide
    • zonisamide 400 mg, 200 mg, or placebo

Arms, Groups and Cohorts

  • Experimental: A
    • Zonisamide 400 mg
  • Experimental: B
    • Zonisamide 200 mg
  • Placebo Comparator: C
    • matching placebo

Clinical Trial Outcome Measures

Primary Measures

  • Change in Body Weight
    • Time Frame: 1 year
    • The primary endpoint was weight loss at 1-year, Month-12 weight minus baseline weight, in kilograms.

Secondary Measures

  • Proportions of Patients With 5% Weight Loss
    • Time Frame: 1 year
    • These were the proportions of patients losing 5% or more weight at 1-year relative to baseline. The measures were modeled with logistic regressions that included the three-level group proxy and a baseline weight covariate.
  • Proportions of Patients With 10% Weight Loss
    • Time Frame: 1 year
    • This outcomes measure followed the same principles at measurement of proportions of patients with 5% weight loss described elsewhere.
  • Waist Circumference
    • Time Frame: 1 year
    • Analyses was based on intent-to-treat ANCOVA. Difference scores from baseline to endpoint (Month-12) for each measure were regressed on the three-level proxy denoting group while controlling for the baseline value of the same measure. Contrasts were subsequently estimated in models, which had a significant overall treatment effect.
  • Inflammatory Markers (CRP)
    • Time Frame: 1 year
    • C reactive Protein (CRP)
  • Change in Lipids
    • Time Frame: baseline, 1 year
  • Quality of Life as Measured by HADS_D
    • Time Frame: 1 year
    • Hospital Anxiety and Depression Scale – Depression (HADS-D) The HADS is a 14-item self-administered questionnaire that consists of 2 scales, one measuring anxiety (HADS-A), and the other measuring depression (HADS-D). Each subscale consists of 7 statements and the participant responds as to how each item applies to him/her over the past week on 4-point response scale. Separate scores are calculated for anxiety and depression and a score (ranging from 0 to 21) is obtained for each subscale. The higher the score, the more severe the anxiety or depression.
  • Change in Blood Pressure
    • Time Frame: Baseline, 1 year

Participating in This Clinical Trial

Inclusion Criteria

Age 18-65 years; BMI 30-50 Exclusion Criteria:

Secondary obesity; Significant cardiovascular disease; Stroke, seizure disorder or other significant neurological disease; Significant liver or gallbladder disease; Significant renal disease or history of kidney stones; HIV positive status; Diabetes mellitus; Untreated or unstable hypothyroidism Malignancy in the past 5 years; Concomitant medications that cause significant weight gain or weight loss; Concomitant use of prescription or OTC weight loss medications; Had bariatric surgery or planning surgery in the next 1 year; Weight change of more than 4 kg in the past 3 months; Suicidal subjects; Major depression in the past 6 months; History of psychosis, bipolar disorder, or severe personality disorders; Subjects taking antipsychotics or mood stabilisers; Alcohol or substance abuse in the past 6 months; Currently taking zonisamide or other antiepileptic drugs; History of hypersensitivity to zonisamide or sulfonamides; Pregnant or planning pregnancy in the next year, or breastfeeding; Severe physical disability; Current participation in a commercial weight loss program or planning to participate; Currently following low-carbohydrate, high protein, high fat diet; Use of investigational medications or devices (current or past 4 weeks) -

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Duke University
  • Collaborator
    • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Kishore M Gadde, MD, Principal Investigator, Duke University

References

Gadde KM, Kopping MF, Wagner HR 2nd, Yonish GM, Allison DB, Bray GA. Zonisamide for weight reduction in obese adults: a 1-year randomized controlled trial. Arch Intern Med. 2012 Nov 12;172(20):1557-64. doi: 10.1001/2013.jamainternmed.99.

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