Effectiveness and safety of liraglutide in the treatment of childhood obesity

Childhood obesity remains one of the leading health problems. Recommendations for diet therapy and lifestyle changes are not always followed by patients and often do not lead to weight loss. The use of the drug liraglutide is promising in the treatment of childhood obesity. Aims — to evaluate the effectiveness and safety of using a glucagon-like peptide-1 analogue (liraglutide) in the treatment of obesity in children. Methods. A single-center prospective uncontrolled study of the use of liraglutide in children aged 12–18 years with constitutionally exogenous obesity for 12 months was conducted. The dynamics of BMI SDS (a reduction of 0.25 units or more), the presence or absence of obesity complications, complaints, and changes in laboratory indicators during the use of the drug were evaluated. Statistical analysis of the data was carried out with calculations of the arithmetic mean (M), standard deviation (SD), 95% confidence intervals, as well as the median and interquartile range (Me [25; 75]). Results. The study included 68 patients aged 12–18 years with obesity of varying degrees: 14 (20.6%) patients with grade II obesity, 40 (58.8%) children with grade III obesity, and 14 (20.6%) patients with morbid obesity. Comorbid conditions were present in 61 (89.7%) children. Non-alcoholic fatty liver disease (in 60.3% of children) and carbohydrate metabolism disorders (in 41.1% of cases) were more frequently registered in children with morbid obesity (p < 0.05). A reduction in BMI SDS was observed in 76.5% of patients, including 47 children who had a reduction of more than 0.25 kg/m². Three (4.4%) children maintained their weight (BMI SDS dynamics ± 0.05), and 7 (10.3%) patients increased their body mass. After 12 months of therapy, body weight decreased from 100,5 ± 19,7 to 99,2 ± 20,5 kg (р < 0,001), an average reduction of 6 kg (5,7%), and BMI SDS from 3,49 ± 0,66 to 2,82 ± 1,12 kg/m² (р < 0,001), an average reduction of 0,67 kg/m² (19.2%). The incidence of arterial hypertension decreased from 30.9 to 4.8% (p < 0.004), carbohydrate metabolism disorders from 41.1 to 19.4% (p = 0.004), dyslipidemia from 20.6 to 9.7%, and non-alcoholic fatty liver disease from 60.3 to 50%. Gastrointestinal side effects were reported by 10 (14.7%) patients during planned dose escalation, and in 5 patients (7.4%), the maximum tolerable dose was 2.4 mg. Conclusions. Liraglutide has shown good efficacy in the treatment of obesity in children — positive body weight dynamics at the end of therapy after 8–12 months was achieved in 76.5% of patients, 4.4% of children stabilized body weight. The decrease in patients’ body weight was accompanied by an improvement in metabolic parameters and a decrease in the detection of obesity complications. Gastrointestinal side effects were noted in 14.7% of patients during dose escalation and did not require discontinuation of therapy thereafter.