February 20, 2013
Diabetes Injectable for Adults Shows Promise in Helping Obese Teens Lose Weight

Minneapolis—Medications widely prescribed to control blood sugar levels in type 2 diabetics could have a different use for teenagers: helping those who are severely obese to lose weight.

A report published online by JAMA Pediatrics said that preliminary evidence from a small 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. The study background notes that 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.

Researchers led by Aaron S. Kelly, PhD, of the University of Minnesota Medical School in Minneapolis, conducted a 3-month, placebo-controlled trial followed by a 3-month open-label extension, during which the injected medication was offered to all patients. The trial was completed by 22 patients, ranging in age from 12 to 19 years old.

“The results of this clinical trial extend the findings of our 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 write.

Exenatide, marketed as Byetta and Bydureon, caused a 2.7% greater reduction in BMI compared with placebo, according to researchers, who also observed a further reduction in BMI during the open-label phase for those patients initially randomized to exenatide. They had a cumulative BMI reduction of 4%. While the therapy also resulted in a reduction, on average, in systolic blood pressure (SMP) of -6mm HG, researchers note it did not reach the level of statistical significance.

“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 write.

In a related editorial, Jeffrey B. Schwimmer, MD, of the University of California, San Diego, notes the urgent need for effective medications to treat the growing problem of obesity in children.

“The need for medication(s) to treat pediatric obesity stems from the frequency and severity of childhood obesity and its complications,” Schwimmer writes, adding, “How to select which children merit treatment with medication and are most likely to benefit from a given treatment is a pressing issue for both clinical care and the research studies on which that care will be based.”

Schwimmer also points out that with new drugs being approved for obesity treatment in adults, “Data on the safety and efficacy of these medications are needed in the pediatric population.”

U.S. Pharmacist Social Connect