Clarissa Marie Arce

Overweight? Obese? Take action! Effects1,2 Cause1,2 Socio-Economic Status Poly Cystic Ovarian Disease (PCOD) Built Environment Cardio Vascular Disease (CVD) Obesity Physical Inactivity Insulin Resistance & Type 2 Diabetes Dietary trends & Habits Genetic/Antenatal Factors Obstructive Sleep Apnea (OSA) Psychosocial Problems DuromineTM weight loss for wellness DuromineTM significantly decreases weight3,4 0 4 8 12 16 Weeks 20 24 28 32 36 Placebo once-daily (con�nuous regimen) + 1,000 Cal/day dietary advice. n=25 DuromineTM 30 mg once-daily (con�nuous regimen) + 1,000 Cal/day dietary advice. n=17 4.5 kg (≈5%) -3 -6 9.2 kg (≈10%) -9 p<0.0014 Duromine vs placebo -12 DuromineTM 30 mg once-daily for 4 weeks alterna�ng with placebo once daily for 4 weeks (alternate regimen) + 1,000 Cal/day dietary advice. n=22 9.7 kg Adapted from Munro et al. -15 DuromineTM doubles weight loss at 12 weeks vs placebo3 A small change for a big difference in health Estimated benefits of 10% weight loss5* *Cause of weight loss unspecified Blood pressure Diabetes People at risk of diabetes Lipids Mortality SBP and DBP in hypertensive patients 10 mmHG Fasting glucose for newly diagnosed patients up to 50% Fasting or 2-hour insulin Insulin sensitivity Incidence of diabetes > 30% > 30% 40-60 Total cholesterol LDL-C Triglycerides HDL-C All-cause mortality Diabetes-related deaths Obesity-related deaths 10% 15% 30% 8% > 20% > 30% > 40% Adapted from Haslam et al 20065 SBP: systolic blood pressure. DBP: diastolic blood pressure. LDL-C: low-density lipoprotein-C. HDL-C: high-density lipoprotein. DuromineTM weight loss for wellness DuromineTM in obese pa�ents with T2DM: DuromineTM may be used with cau�on in pa�ents with diabetes6-8 Weight loss and metabolic improvements9 Diabetic Patient FPG Reduction Metabolic Improvements Use in Diabetics Response to insulin and oral hypoglycemic agents may vary due to changes in dietary habits while taking DuromineTM6 Weight loss may reduce the requirement for diabetes medications7-8 T2DM: type 2 diabetes mellitus. FPG: fasting plasma glucose. Phentermine in obese pa�ents with and without T2DM: Weight loss and SBP reduction* DuromineTM may be used with cau�on in pa�ents with mild*, controlled hypertension6 10,11 *SBP < 159 mmHg, DBP < 99 mmHg Mean Weight loss Mean SBP Reduction Mean DBP Reduction *Overall responders 6.4% (P < .001) 3.4 mmHg (P < .05) Not significant *Obese without diabetes 10.4 kg (P < .001) 6.2 mmHg (P = .09) Not significant HbA1c Obese with diabetes > 6.5% 4.1 kg 6% to 6.5% 3.2 kg < 6% 7.4 kg Monitor in blood pressure in the first days of treatment to determine that there is no loss of blood pressure control. Not significant Phentermine in obese pa�ents with hypertension: Weight loss without increase in SBP, DBP, or HR12 5 Weight loss, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) change by weeks/years of therapy. 0 -5 Phentermine-treated hypertensive subjects: weight P ≤ 0.0001, SBP week 26, 52, 104, 156 P ≤ 0.0001, week 208 P = 0.0217, week 260 P = 0.0074, week 312 P = 0.0047, DBP week 26, 52, 104 P < 0.0001, week 156 P = 0.0002, week 208 P = 0.0041, 260 P > 0.05, week 312 P > 0.05, HR P > 0.05.12 -10 -15 - DuromineTM safety profile Phentermine – Schedule IV Drug Classifica�on by the U.S. Drug Enforcement Agency (very low poten�al for drug abuse).13 Prescribe with confidence in 50 years of global clinical experience6,14 > 50 years of clinical experience14 > 50 million prescrip�ons wri�en worldwide4 In post-marke�ng surveillance no safety signal was detected with phentermine monotheraphy that required a change in prescribing informa�on.15 Contraindications6 Full drug prescribing information is available upon request. Mailing Address: Unit 2802 Penthouse One Global Place 25th St cor 5th Ave, BGC 1634 Taguig City, Philippines Contact Information: Tel: (- Website: http://www.inovapharma.com References: 1. The Health Effects of Overweight and Obesity. Healthy Weight. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/effects/index.html 2. The Impact of Obesity on Your Body and Health. American Society for Metabolic and Bariatric Surgery. https://asmbs.org/patients/impact-of-obesity 3. Munro JF, et al. Comparison of continuous and intermittent anorectic therapy in obesity. BMJ. 1968; 1(5588): 352-4. 4. Glazer G. Long-term pharmacotherapy of obesity 2000: a review of efficacy and safety. Arch Int Med. 2001;161:-. Haslam D, Sattar N, Lean M. Obesity—time to wake up. BMJ. 2006;333:640-2. 6. Duromine Product Information, November 2013. 7. Miles JM, et al. Effect of Orlistat in overweight and obese patients with type 2 diabetes treated with metformin. Diabetes Care. 2002;25:1123-8. 8. Redmon JB, et al. One-year outcome of a combination of weight loss therapies for subjects with type 2 diabetes: a randomized trial. Diabetes Care. 2003;26:-. Gershberg H, et al. Effects of diet and an anorectic drug (phentermine resin) in obese diabetics. Curr Ther Res. 1977;22:-. Ahmed R, et al. Abstract #616. Presented at: AACE Annual Scientific and Clinical Congress; May 3-7, 2017; Austin, Texas. 11. Cox A. Phentermine lowers weight, systolic BP in adults with obesity. Highlights from AACE. http://www.empr.com/aace-2017/phentermine-diabetes-systolic-blood-pressure-anti-obesity/article/652535/ 12. Hendricks EJ, et al. Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity. Obesity (Silver Spring). 2011;19(12):-. Glandt M, Raz I. Present and future: pharmacologic treatment of obesity. J Obes. 2011;2011:-. FDA, 7 July 2005. Questions and Answers about Withdrawal of Fenfluramine (Pondimin) and Dexfenfluramine (Redux). http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm180078.htm 15. Data on file, iNova Pharmaceuticals.