A Randomized, Double-Blind, Placebo-Controlled Study of an Oral, Extended- Release Formulation of Phentermine/Topiramate for the Treatment of Obstructive Sleep Apnea in Obese Adults

1529 Study of Phentermine/Topiramate as a Treatment for OSA—Winslow et al INTRODUCTION Obstructive sleep apnea (OSA) is a condition in which individuals experience multiple nighttime episodes of apnea or hypopnea, during which blood oxygen saturation levels fall and normal sleep architecture is disrupted.1,2 OSA affects more than 15 million adults in the United States and becomes more prevalent with increased age.3,4 The current standard of care for OSA is positive airway pressure (PAP); however, it only provides benefits when used and does not consistently address the pathophysiology of OSA.5 When acceptance and adherence are considered, the success rate of PAP therapy can be as low as 50%, and currently, there are no pharmacologic therapies indicated for the treatment of OSA.5-7 The altered physiology induced by the periodic hypoxia and reoxygenation that characteristically occur in OSA result in oxidative stress, endothelial dysfunction, sympathetic activation, and activation of the inflammatory cascade, all of which favor cardiovascular disease and related comorbidities, includRANDOMIZED TRIAL OF EXTENDED-RELEASE PHENTERMINE/TOPIRAMATE FOR OSA