Update on Pediatric Anti-obesity Medications—Current Landscape and Approach to Prescribing

Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics. 2023;151(2): e2022060640.

Article  PubMed  Google Scholar 

Zhao G, Zhang Q, Wu F, Yin S, Xie Y, Liu H. Comparison of weight loss and adverse events of obesity drugs in children and adolescents: a systematic review and meta-analysis. Expert Rev Clin Pharmacol. 2022;15(9):1119–25.

Article  CAS  PubMed  Google Scholar 

Hvizdos KM, Markham A. Orlistat: a review of its use in the management of obesity. Drugs. 1999;58(4):743–60.

Article  CAS  PubMed  Google Scholar 

Orlistat [package insert]. Nutley (NJ): Roche laboratories, Inc; 1999.

Ozkan B, Bereket A, Turan S, Keskin S. Addition of orlistat to conventional treatment in adolescents with severe obesity. Eur J Pediatr. 2004;163(12):738–41.

Article  PubMed  Google Scholar 

Chanoine JP, Hampl S, Jensen C, Boldrin M, Hauptman J. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005;293(23):2873.

Article  CAS  PubMed  Google Scholar 

Maahs D, de Serna DG, Kolotkin RL, Ralston S, Sandate J, Qualls C, et al. Randomized, double-blind, placebo-controlled trial of orlistat for weight loss in adolescents. Endocr Pract. 2006;12(1):18–28.

Article  PubMed  Google Scholar 

Jackson IMD, Whyte WG. Chlorphentermine S.A. in the treatment of obesity and the effect of weight loss on steroid excretion. BMJ. 1965;2(5459):453–5.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ryder JR, Kaizer A, Rudser KD, Gross A, Kelly AS, Fox CK. Effect of phentermine on weight reduction in a pediatric weight management clinic. Int J Obes. 2017;41(1):90–3.

Article  CAS  Google Scholar 

Hsia DS, Gosselin NH, Williams J, Farhat N, Marier JF, Shih W, et al. A randomized, double-blind, placebo-controlled, pharmacokinetic and pharmacodynamic study of a fixed-dose combination of phentermine/topiramate in adolescents with obesity. Diabetes Obes Metab. 2020;22(4):480–91.

Article  CAS  PubMed  Google Scholar 

•• Kelly AS, Bensignor MO, Hsia DS, Shoemaker AH, Shih W, Peterson C, Varghese ST. Phentermine/topiramate for the treatment of adolescent obesity. NEJM Evid. 2022;1(6):10. https://doi.org/10.1056/evidoa2200014. Phentermine/topiramate has not previously been examined for efficacy and safety in a major randomized controlled trial in adolescents. With GLP-1 receptor agonist shortages, prescribers’ abilities and comfort levels to prescribe other AOMs is vital.

Farr OM, Tsoukas MA, Triantafyllou G, Dincer F, Filippaios A, Ko BJ, et al. Short-term administration of the GLP-1 analog liraglutide decreases circulating leptin and increases GIP levels and these changes are associated with alterations in CNS responses to food cues: a randomized, placebo-controlled, crossover study. Metabolism. 2016;65(7):945–53.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Flint A, Raben A, Astrup A, Holst JJ. Glucagon-like peptide 1 promotes satiety and suppresses energy intake in humans. J Clin Invest. 1998;101(3):515–20.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Schlögl H, Kabisch S, Horstmann A, Lohmann G, Müller K, Lepsien J, et al. Exenatide-induced reduction in energy intake is associated with increase in hypothalamic connectivity. Diabetes Care. 2013;36(7):1933–40.

Article  PubMed  PubMed Central  Google Scholar 

• Kelly AS, Auerbach P, Barrientos-Perez M, Gies I, Hale PM, Marcus C, et al. A randomized, controlled trial of liraglutide for adolescents with obesity. N Engl J Med. 2020;382(22):2117–28.  This trial demonstrates the efficacy of using a daily GLP-1 receptor agonist.

Article  CAS  PubMed  Google Scholar 

• Weghuber D, Barrett T, Barrientos-Pérez M, Gies I, Hesse D, Jeppesen OK, et al. Once-weekly semaglutide in adolescents with obesity. N Engl J Med. 2022;387(24):2245–57. This trial was important in demonstrating efficacy of a weekly GLP-1 receptor agonist in adolescents to then lead to FDA approval for adolescent use.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kühnen P, Clément K, Wiegand S, Blankenstein O, Gottesdiener K, Martini LL, et al. Proopiomelanocortin deficiency treated with a melanocortin-4 receptor agonist. N Engl J Med. 2016;375(3):240–6.

Article  PubMed  Google Scholar 

Kühnen P, Clément K. Long-term MC4R agonist treatment in POMC-deficient patients. N Engl J Med. 2022;387(9):852–4.

Article  PubMed  Google Scholar 

Clément K, Biebermann H, Farooqi IS, Van der Ploeg L, Wolters B, Poitou C, et al. MC4R agonism promotes durable weight loss in patients with leptin receptor deficiency. Nat Med. 2018;24(5):551–5.

Article  PubMed  Google Scholar 

Clément K, Van Den Akker E, Argente J, Bahm A, Chung WK, Connors H, et al. Efficacy and safety of setmelanotide, an MC4R agonist, in individuals with severe obesity due to LEPR or POMC deficiency: single-arm, open-label, multicentre, phase 3 trials. Lancet Diabetes Endocrinol. 2020;8(12):960–70.

Article  PubMed  Google Scholar 

Haqq AM, Chung WK, Dollfus H, Haws RM, Martos-Moreno GÁ, Poitou C, et al. Efficacy and safety of setmelanotide, a melanocortin-4 receptor agonist, in patients with Bardet-Biedl syndrome and Alström syndrome: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial with an open-label period. Lancet Diabetes Endocrinol. 2022;10(12):859–68.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Okuyaz CMD, Kursel OMD, Komur MMD, Tamer LMD. Evaluation of appetite-stimulating hormones in prepubertal children with epilepsy during topiramate treatment. Pediatr Neurol. 2012;47(6):423–6.

Article  PubMed  Google Scholar 

McElroy SL, Hudson JI, Capece JA, Beyers K, Fisher AC, Rosenthal NR. Topiramate for the treatment of binge eating disorder associated with obesity: a placebo-controlled study. Biol Psychiatry 1969. 2007;61(9):1039–48.

CAS  Google Scholar 

Zheng H, Patterson C, Berthoud HR. Behavioral analysis of anorexia produced by hindbrain injections of AMPA receptor antagonist NBQX in rats. Am J Physiol-Regul Integr Comp Physiol. 2002;282(1):R147–55.

Article  CAS  PubMed  Google Scholar 

Berman C, Naguib M, Hegedus E, Vidmar AP. Topiramate for Weight Management in Children With Severe Obesity. Child Obes. 2023;19(4):219–25. https://doi.org/10.1089/chi.2022.0062.

Article  PubMed  Google Scholar 

Fox CK, Marlatt KL, Rudser KD, Kelly AS. Topiramate for weight reduction in adolescents with severe obesity. Clin Pediatr (Phila). 2015;54(1):19–24.

Article  PubMed  Google Scholar 

Fox CK, Kaizer AM, Rudser KD, Nathan BM, Gross AC, Sunni M, et al. Meal replacements followed by topiramate for the treatment of adolescent severe obesity: a pilot randomized controlled trial. Obesity. 2016;24(12):2553–61.

Article  CAS  PubMed  Google Scholar 

Khazaal YMD, Chatton AMA, Rusca MBA, Preisig MMD, Zullino DMD. Long-term topiramate treatment of psychotropic drug-induced weight gain: a retrospective chart review. Gen Hosp Psychiatry. 2007;29(5):446–9.

Article  PubMed  Google Scholar 

Wang C, Shi W, Xu J, Huang C, Zhu J. Outcomes and safety of concomitant topiramate or metformin for antipsychotics-induced obesity: a randomized-controlled trial. Ann Gen Psychiatry. 2020;19:1–10.

Article  CAS  Google Scholar 

Rena G, Hardie DG, Pearson ER. The mechanisms of action of metformin. Diabetologia. 2017;60(9):1577–85.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Mulherin AJ, Oh AH, Kim H, Grieco A, Lauffer LM, Brubaker PL. Mechanisms underlying metformin-induced secretion of glucagon-like peptide-1 from the intestinal L cell. Endocrinology. 2011;152(12):4610–9.

Article  CAS  PubMed  Google Scholar 

DeFronzo RA, Buse JB, Kim T, Burns C, Skare S, Baron A, et al. Once-daily delayed-release metformin lowers plasma glucose and enhances fasting and postprandial GLP-1 and PYY: results from two randomised trials. Diabetologia. 2016;59(8):1645–54.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ford JL, Gerhart JG, Edginton AN, Yanovski JA, Hon YY, Gonzalez D. Physiologically based pharmacokinetic modeling of metformin in children and adolescents with obesity. J Clin Pharmacol. 2022;62(8):960–9.

Article  CAS  PubMed  PubMed Central  Google Scholar 

McDonagh MS, Selph S, Ozpinar A, Foley C. Systematic review of the benefits and risks of metformin in treating obesity in children aged 18 years and younger. JAMA Pediatr. 2014;168(2):178–84.

Article  PubMed  Google Scholar 

Carreras-Badosa G, Gómez-Vilarrubla A, Mas-Parés B, Martínez-Calcerrada JM, Xargay-Torrent S, Prats-Puig A, et al. A 24-month metformin treatment study of children with obesity: changes in circulating GDF-15 and associations with changes in body weight and visceral fat. Pediatr Obes. 2022;17(2): e12845.

Article  PubMed  Google Scholar 

Concepcion JQ, Tucker LY, Huang K. Metformin for pediatric obesity and insulin resistance: a retrospective study within an integrated health care system. Obesity. 2021;29(9):1526–37.

Article  CAS  PubMed  Google Scholar 

Asanka de Silva V, Suraweera C, Ratnatunga SS, Dayabandara M, Wanniarachchi N, Hanwella R. Metformin in prevention and treatment of antipsychotic induced weight gain: a systematic review and meta-analysis. BMC Psychiatry. 2016;16(1):341.

Article  Google Scholar 

Ermer JC, Pennick M, Frick G. Lisdexamfetamine dimesylate: prodrug delivery, amphetamine exposure and duration of efficacy. Clin Drug Investig. 2016;36(5):341–56.

Article 

留言 (0)

沒有登入
gif