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GLP-1 Agonists May Be Effective for Obese Adolescents

Preliminary evidence from a clinical trial suggests that treatment with GLP-1 receptor agonists was associated with….

Preliminary evidence from a clinical trial suggests that treatment with glucagon-like peptide-1 (GLP-1) receptor agonists was associated with reduced body mass index and body weight in adolescents with severe obesity, according to a report published online by JAMA Pediatrics, a JAMA Network publication.

According to the study, GLP-1 receptor agonist therapy, approved for adults with type 2 diabetes mellitus, reduces body weight by enhancing satiety and suppressing appetite, even in patients without diabetes.

Aaron S. Kelly, Ph.D., of the University of Minnesota Medical School, Minneapolis, and colleagues conducted a three-month, placebo-controlled trial followed by a three-month open-label extension during which medication was offered to all patients. A total of 22 patients (12 to 19 years of age) completed the trial, in which the medication exenatide was administered subcutaneously.

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“The results of this clinical trial extend the findings of the previous pilot and feasibility study and offer additional evidence, within the context of a randomized, placebo-controlled trial, that treatment with a GLP-1 receptor agonist significantly reduces BMI and body weight in adolescents with severe obesity,” the authors note.

Exenatide caused a greater reduction in BMI compared with placebo (-2.7 percent). Researchers also observed a further reduction in BMI during the open-label phase for those patients initially randomized to exenatide (cumulative BMI reduction of 4 percent). The medication also resulted in a reduction, on average, in systolic blood pressure of 6mm HG, although researchers note it did not reach the level of statistical significance.

The researchers write that there are few treatments available for severely obese children outside of lifestyle changes and surgery, and they wanted to see if the weight loss seen in adults would also happen in children.

“In conclusion, data from the current study provide evidence that GLP-1 receptor agonist treatment reduces BMI and elicits a potentially meaningful reduction in SBP in adolescents with severe obesity,” the authors conclude.

In a related editorial, Jeffrey B. Schwimmer, M.D., of the University of California, San Diego, writes: “The need for medication(s) to treat pediatric obesity stems from the frequency and severity of childhood obesity and its complications.”

Parents and their children should not expect to get exenatide right now, because it is not approved for use in children for weight loss. Researchers wrote, “We’re really viewing this as preliminary evidence for this general drug class. We wouldn’t recommend this medication to be used (for weight loss in youths) at this point.”

JAMA Pediatr. Published online February 4, 2013. doi:10.1001/jamapediatrics.2013.1045.