{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T19:08:25Z","timestamp":1775329705513,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T00:00:00Z","timestamp":1510876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2018,1]]},"abstract":"Study Objective<\/jats:title>To compare the effectiveness of weight\u2010management medications used to assist with weight loss in real\u2010world clinical practice in the Veterans Health Administration (VHA<\/jats:styled-content>).<\/jats:p><\/jats:sec>Design<\/jats:title>Retrospective, multicenter, observational cohort study.<\/jats:p><\/jats:sec>Data Source<\/jats:title>National VA<\/jats:styled-content> Corporate Data Warehouse.<\/jats:p><\/jats:sec>Patients<\/jats:title>A total of 66,035 VA<\/jats:styled-content> patients aged 18 years or older with a body mass index of 25 kg\/m2<\/jats:sup> or greater who had an initial fill for a study medication (orlistat [6153 patients], phentermine [304 patients], lorcaserin [298 patients], or phentermine\u2010topiramate extended release [233 patients]) or participation in the VA<\/jats:styled-content>'s MOVE<\/jats:styled-content>! weight\u2010management program with at least three total visits in a clinic coded as a MOVE<\/jats:styled-content> clinic in the subsequent 24 weeks (59,047 patients) between January 1, 2012, and July 1, 2016.<\/jats:p><\/jats:sec>Measurements and Main Results<\/jats:title>The primary outcome was the percentage change in weight from baseline to at least 20 weeks or later (i.e., closest weight to 6 months). Secondary outcomes were difference in the percentage of weight loss at 12 and 36 weeks; changes in blood pressure, hemoglobin A1c<\/jats:sub>, high\u2010density and low\u2010density lipoprotein cholesterol and triglyceride levels; and percentage of patients who achieved at least a 5% and 10% weight loss at 6 months from baseline in each group after at least 20 weeks. For the primary outcome, the percentage decrease in weight from baseline after at least 20 weeks in the lorcaserin, phentermine\u2010topiramate, phentermine, orlistat, and MOVE<\/jats:styled-content>! groups were 3.6%, 4.1%, 3.6%, 2.1%, and 1.6%, respectively (phentermine\u2010topiramate group vs. MOVE<\/jats:styled-content>! group, p<0.05). Achievement of at least a 5% weight loss after at least 20 weeks differed significantly among groups, ranging from 26.2% for the MOVE<\/jats:styled-content>! Program only group to 40.3% for patients in the phentermine\u2010topiramate group.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In the VA<\/jats:styled-content> population, the effectiveness of four available weight\u2010management medications was similar. Patients receiving phentermine\u2010topiramate had a greater proportion of weight loss after at least 20 weeks compared with those solely enrolled in the VA<\/jats:styled-content>'s MOVE<\/jats:styled-content>! weight\u2010management program.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2048","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T05:18:41Z","timestamp":1508217521000},"page":"19-28","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Observational Comparative Effectiveness of Pharmaceutical Treatments for Obesity within the Veterans Health Administration"],"prefix":"10.1002","volume":"38","author":[{"given":"Ted R.","family":"Grabarczyk","sequence":"first","affiliation":[{"name":"Clinical Pharmacy Services VA Eastern Kansas Healthcare System Topeka Kansas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.2014"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.5.w822"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61836-X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20660"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP15693.CS"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3415"},{"key":"e_1_2_7_8_1","unstructured":"The Management of Overweight and Obesity Working Group Screening and management overweight and obesity.VA\/DoD clinical practice guideline.2014;2.0."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61375-1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.3.235"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-7-200504050-00012"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801889"},{"key":"e_1_2_7_13_1","unstructured":"Adipex\u2010P Prescribing Information.U.S. Food and Drug Administration website. Available fromhttps:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2012\/085128s065lbl.pdf. Last Updated January 2012. Accessed August 5 2017."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1256"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909809"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2012.66"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2011.330"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60205-5"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.024927"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281361"},{"key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1001\/jama.2016.7602","article-title":"Association of pharmacological treatments of obesity with weight loss and adverse events: a systemic review and meta\u2010analysis","volume":"315","author":"Khera R","year":"2016","journal-title":"JAMA"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-016-3949-y"},{"key":"e_1_2_7_23_1","unstructured":"MOVE! Weight Management Program. Department of Veterans Affairs website. Available fromhttps:\/\/www.move.va.gov\/. Updated July 18 2017. 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