ESPE Abstracts

Introduction: The prevalence of childhood obesity is continuing to increase worldwide and has become a major health concern. There are a number of serious complications to childhood obesity with significant long-term health implications if not managed in a timely matter. These complications include type 2 diabetes mellitus (T2DM), obstructive sleep apnoea (OSA), idiopathic intracranial hypertension (IIH) and non-alcoholic fatty liver disease (NAFLD). At present, lifestyle intervention is the recommended treatment option for childhood obesity and unfortunately, this is only successful in a small number of individuals. Glucagon-like peptide 1 (GLP-1) therapy has shown promising results for weight loss in adults, but data remains limited in the paediatric population.

Methods: Patients with significant complications secondary to obesity (including T2DM, insulin resistance, IIH, OSA, dyslipidaemia, hepatic fibrosis, delayed puberty and depression) attended a multidisciplinary team (MDT) weight management clinic. Individuals were started on once-daily subcutaneous Liraglutide injections and were seen every two weeks. Liraglutide was started at 0.6mg daily and increased, if required, to a maximum dose of 3mg.

Results: 7 patients have completed a 3-month treatment course of Liraglutide, with 3 of the patients completing 6 months in total. All patients are female with a mean age of 14.9 years (range: 13-16 years). Mean percentage weight loss was 4.2% (1.2-9.7%) and 5.8% (4-8.2%) at 3 and 6 months, respectively. Significant weight loss (5.3kg, 95%CI 1.93-8.78, P = 0.009) and significant reduction in body mass index [BMI] (2.09kg/m², 95% CI 0.97-3.20, P = 0.004) was noted at 3 months of treatment. This further continued with weight loss (6.9kg, 95% CI 1.33-12.53, P = 0.033) and BMI reduction (2kg/m², 95% CI 0.06-3.94, P = 0.047) being significant at 6 months of treatment. During this period, one patient was able to discontinue acetazolamide as her IIH had resolved and another patient showed resolution of steatohepatitis. No side effects were reported due to Liraglutide.

Conclusion: The results have shown significant weight loss and BMI reduction in a cohort of adolescents following Liraglutide treatment over a 3 and 6-month period, along with an intense lifestyle programme supported by a dedicated MDT. These results show that the use of Liraglutide within an MDT setting could be a potential treatment option for children and young people with significant complications secondary to obesity.