BackgroundTo assess the efficacy and safety of topiramate in treating binge eating disorder (BED), using a systematic review and meta-analysis of the available randomized clinical trials (RCTs).MethodsThe RCTs assessing topiramate vs placebo with or without adjunctive psychotherapy in BED were reviewed using a systematic search in the PubMed, Web of Science, PsycINFO, Cochrane Database of Systematic Review, and ClinicalTrials.gov search Websites, from inception to November 2019. Main outcomes were the changes in binge frequency, quality of life, and weight, respectively. Effect estimates were pooled using random-effect models and presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence interval (95% CI). Data extraction was performed by two independent reviewers.ResultsThree studies were eligible for inclusion, involving 528 BED patients. Topiramate was found to be significantly more efficacious than placebo in reducing: (a) the number of binge episodes per week (MD = −1.31; 95% CI = −2.58 to −0.03; I2 = 94%); (b) the number of binge days per week (MD = −0.98; 95% CI = −1.80 to −0.16; I2 = 94%); and (c) weight (MD = −4.91 kg; 95% CI = −6.42 to −3.41; I2 = 10%). However, participants in the topiramate groups withdrew significantly more frequently for safety reasons, relative to placebo participants (RR = 1.90; 95% CI = 1.13-3.18, I2 = 0%).ConclusionsPreliminary findings support a possible efficacy of topiramate for the treatment of BED, even if safety concerns could limit the practical use of this treatment in BED subjects.

中文翻译：

---

托吡酯治疗暴食症的疗效和安全性：系统评价和荟萃分析

背景为了评估托吡酯治疗暴食症 (BED) 的疗效和安全性，对现有的随机临床试验 (RCT) 进行系统评价和荟萃分析。从开始到 2019 年 11 月，在 PubMed、Web of Science、PsycINFO、Cochrane 系统评价数据库和 ClinicalTrials.gov 搜索网站中进行系统搜索。主要结果分别是暴饮暴食频率、生活质量和体重的变化. 使用随机效应模型汇总效应估计值，并以风险比 (RR) 或平均差 (MD) 及其 95% 置信区间 (95% CI) 的形式呈现。数据提取由两名独立评审员进行。结果三项研究符合纳入条件，涉及 528 名 BED 患者。托吡酯被发现比安慰剂更有效地减少：（a）每周暴食发作的次数（MD = -1.31；95% CI = -2.58 至 -0.03；一世2= 94%); (b) 每周暴饮暴食的天数（MD = -0.98；95% CI = -1.80 至 -0.16；一世2= 94%); (c) 体重（MD = -4.91 kg；95% CI = -6.42 至 -3.41；一世2= 10%）。然而，相对于安慰剂参与者，托吡酯组参与者出于安全原因退出的频率更高（RR = 1.90；95% CI = 1.13-3.18，一世2= 0%)。结论初步研究结果支持托吡酯治疗 BED 的可能功效，即使安全问题可能会限制这种治疗在 BED 受试者中的实际使用。