ESPE Abstracts

Introduction: The Glucagon-like Peptide(GLP1)-analogue liraglutide is the first drug approved for the treatment of obesity in adolescents in Europe. While clinically relevant effects of liraglutide treatment in adolescents with obesity had been shown in a phase III study, there are no reports about the use under real-life conditions in these patients. Our aim was to report the effect of treatment with liraglutide on body weight loss in a cohort of adolescents with extreme obesity, including also patients with genetic obesity.

Methods: Data from n=13 patients (n=9 female) for whom liraglutide treatment was initiated after unsuccessful multidisciplinary lifestyle intervention were retrospectively analyzed (age T0:16.2±4.3 years; BMI-SDS T0:3.4±0.7). Dosing started at 0.6mg and was increased up to max 3.0mg. Molecular genetic testing of relevant obesity genes was performed initially. Anthropometric parameters (body height (m), body weight (kg)) were collected at T0 (baseline), T1 (3 months), T2 (6 months) and T3 (9 months) after treatment start. Changes in percentage body weight (∆%BW) and BMI-SDS (∆BMI-SDS) were evaluated.

Results: Molecular genetic abnormalities were diagnosed in n=5 patients (MC4R:c.253A>G (hom) +MC4R:c.802T>C (hom); POMC:c.641A>G (het); proximal microdeletion syndrome 16p11.2 (n=2); NTRK2:c.446C>T (het)). The mean reduction in %BW T0-T1 after 3 months was -4.8±3.1%. The mean reduction in BMI-SDS T0-T1 was -0.17±0.19. In three patients, gratifying weight reduction was already achieved after three months with a dosage of only 1.2 or 1.8mg/d (range ∆BW T0-T1:4.8 to 9.6%). Patients with genetic causes of obesity also achieved a %BW reduction of >5% in the first 3 months. Mean %BW reduction was -8.2±4.3% (∆BMI-SDS T0-T2:-0.29±0.20) and -9.5±7.3% (∆BMI-SDS T0-T3:-0.34±0.31) after 6 and 9 months of liraglutide treatment. Side effects such as nausea, vomiting, stomach pain and obstipation were reported in five patients during the gradual dose escalation. No side effects were reported after six months of treatment. The patients reported a significant reduction of their hunger feelings and asked for continuation of liraglutide treatment.

Conclusion: This case series of adolescents with extreme obesity, including also adolescents with genetic obesity, shows that treatment with liraglutide up to 3.0mg results in clinically significant weight loss in the first 9 months under real-life conditions. For their first time in life, the patients achieved a clinically significant weight loss.