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“I don’t think we have enough data to say whether these are serious issues or not,” said Michael Prochan, a statistician with the National Institutes of Health. “I think if we had had longer follow-up I could have voted the other way.”

Panelists who favored the drug said they hoped the FDA would still approve Qnexa, despite the vote results.

“I think if this drug is disapproved we’re going to send a very negative signal to the overweight and obese that drives them away from medical treatment” and toward more unproven weight loss methods, said Ed Hendricks, director of the Center for Weight Management in Sacramento.

Even FDA staff expressed surprise at the panel’s ruling.

“You got the sense that a lot of people had a little bit of hesitancy,” said Eric Coleman, deputy director of the FDA’s metabolism division. “They weren’t strongly against the drug but they had enough concerns to make them lean towards ‘no.’”

Qnexa is a combination of two older drugs: the amphetamine phentermine and topiramate, an anticonvulsant drug sold by Johnson & Johnson as Topamax. According to the company, phentermine helps suppress appetite, while topiramate makes patients feel more satiated.

Vivus representatives told panelists the company’s drug fills an important gap between current treatment options.

Current weight loss drugs on the market such as Roche’s Xenical and Abbott Laboratory’s Meridia offer weight loss in the five percent range. Bariatric surgery can help patients lose 30 to 35 percent, though complications with the operation can be life-threatening.

The quest for a blockbuster weight loss drug has been plagued for decades by safety issues. The most notable was Wyeth’s diet pill-drug combination, fen-phen, which was pulled off the market in 1997 because of links to heart-valve damage and lung problems.