ESPE Abstracts

Introduction: GLP-1 analogues are promising agents for the pharmacotherapy of obesity due to their combined effect on metabolic signalization and eating behavior. The GLP-1 analog liraglutide is registered in Europe for therapy of obese adolescents aged 12-17 years since 2021. According to clinical studies, liraglutide administration leads to a mean weight loss 4.6%. We summarize early real-life experience with this novel therapy.

Patients and methods: Nine boys were treated with liraglutide under the supervision of out-patient clinic for obesity of Department of Pediatrics, University Hospital Motol, between September 2021 and January 2023. At treatment onset, they were 12.0-16.5 years old (median 15), and had body weight 74-188 Kg (median 123) and BMI 30.7-65.9 Kg/m² (median 38.6). Therapy was initiated following failure of conventional treatment including behavioral and psychological intervention.

Results: After the early-phase dose escalation, the long-term daily treatment dose stabilized at 1.8-3.0 mg (median 2.4). Therapy was accompanied by nutritional and behavioral intervention. By the latest check-up following 4-15 months on therapy (median 6), BMI declined to 31.5-61.6 Kg/m² (median 35.6; P<0.05 vs. treatment onset). BMI dropped by 6.5% (median; range -12.7 to +3.0%; P<0.05). The current body weight ranges from 79 to 177 Kg (median 114). Therapy was discontinued in two boys due to limited success, and is ongoing in all others. Treatment related adverse events were minimal.

Conclusion: Liraglutide may contribute to stabilization or reduction of body weight and BMI in a significant proportion of severely obese adolescents, and may serve as a starting point for the further life-long obesity management. The real-life experience is mimicking the previous results from clinical studies, with a modest albeit significant positive effect on decreasing BMI, and just a few patients escaping from the treatment effect, apparently due to limited compliance.