Phentermine/topiramate combination therapy is approved for weight management and promotes weight loss, improves glycemic control, and increases urinary pH. A study investigated whether this combination could also reduce uric acid nephrolithiasis (UAN) in patients with obesity and diabetes. The study included 19 patients (mean age: 62.1 years) with obesity, diabetes, urine pH <5.8, normal renal function, and uric acid-predominant stones.

Over 18 months, 15 patients completed the study, with 73% medication adherence and no serious adverse events attributed to the study medication. In the intention-to-treat analysis, stone volume decreased by 52% in the phentermine/topiramate group compared with an 8.6% increase in the control group, although the between-group difference was not statistically significant (P=.10). The per-protocol analysis showed a statistically significant reduction in…