Single center experience on using Liraglutide in adolescents with obesity +/- Type 2 diabetes

Hajar Dauleh; Maheen Pasha; Hoda Gad; Basma Harris; Amal Khalifa; Goran Petroveski; Houda Afyoni; Saira Shehzad; Shiga Chirayath; Ghassan Mohamadsalih; Shaymaa Mohammed; Rayaz Malik; Khalid Hussain

Background: Childhood obesity is recognized as a chronic illness with limited therapeutic options. Addressing this condition through lifestyle interventions has proven to be challenging, particularly for adolescents, with only minimal outcomes observed. The use of GLP-1 agonists (such as Liraglutide) for reducing body weight in pediatric patients has yielded conflicting results. To date, no studies conducted in the Middle East have reported on the outcomes of GLP-1 receptor agonists in the treatment of obesity, both with and without diabetes, in children and adolescents. Our study represents the first investigation of Liraglutide utilization for weight reduction in this population within the region.

Methods: The study included 22 obese participants with or without type II diabetes, ages 12-19 years, who attended endocrine clinics between 2020-2022—inclusion criteria of Z score +2, free of chronic diseases. The study consisted of 18 months of liraglutide treatment period, with follow-up appointments at 6 months intervals. The primary outcome was changes in weight and BMI at 18 months compared to baseline. Biochemical markers were taken at baseline, 6 months, 12 months, and 18 months to monitor HbA1c changes and detect possible adverse effects on the liver enzymes, pancreas, and kidney function test.

Results: Of the 22 patients, 12 continued till 18 months, and 10 did not comply with the treatment or stopped the medications early due to side effects. 6 out of 12 patients who completed the entire duration were Type 2 Diabetic. At baseline, the weight, weight SDS, BMI, and BMI SD were 113.9kg, 2.9, 40.9 kg/m2, 2.6 respectively. At the 18-month follow-up, the weight, SDS, BMI, and BMI SD were 117.8kg, 2.6, 39kg/m2, and 2.5, respectively. Thus no statistically significant change in the weight parameters were evident at the 18-months compared to baseline. Dropout from the study and poor compliance was high (10 out of 22 patients) due to side effects, mainly gastrointestinal (nausea, abdominal pain, diarrhea, and vomiting). No statistically significant differences were observed between obese vs. obese with type 2 diabetes. No significant change in HbA1c between the baseline and the treatment follow-up in the diabetes patients. No adverse effects (in terms of impairment of liver and kidney function or pancreatitis) were observed.

Conclusions: Real-life experience in clinical practice can vary significantly from clinical trials. In our study participants experienced significant gastrointestinal adverse events effecting their mood, productivity, and lifestyle. Also the time interval between the follow up periods affected the motivational levels of participants. Obese patients being treated with Liraglutide need a multidisciplinary team approach to tackle all aspects of their treatment.

ESPE Abstracts

P1-452