ESPE Abstracts

Introduction: Childhood obesity is associated with various physical and mental health co-morbidities. Lifestyle interventions remain the mainstay of management in children & young people (CYP) with obesity. Semaglutide, a Glucagon-like peptide 1(GLP1) analogue, is licensed for managing obesity in CYP older than 12 years of age.

Aim: The aimof this study is to look at the effects of semaglutide on glycaemic status, body composition, cardiometabolic variables, and quality of life (QoL) in CYP with severe obesity (BMI >99.6^th percentile) and complications.

Methods: 15 [F=5] adolescents (mean age; 14.8 [±1.6] years) with severe obesity (mean weight; 134.7 [±25.6] kg and mean BMI; 46.4 [±5.5] kg/m2) and related complications (excluding T2DM) were started on Semaglutide subcutaneous injection at a dose of 0.25 mg once weekly and escalated gradually to 2.4 mg weekly or maximal tolerated dose over several weeks. Assessments at baseline and 3 months included body measurements, body composition (TANITA: RD-545-SV device), fasting metabolic profile, continuous glucose monitoring (CGM) and QoL questionnaire (PedsQL 4.0 generic scale). The adolescents continued to receive multidisciplinary input from the tier 3 weight management service along with monthly telephone reviews by the specialist nurse to ensure compliance and tolerance.

Results: 84.6% had biochemical evidence of insulin resistance with 3 had impaired glucose tolerance. The baseline CGM data revealed evidence of glycaemic dysregulation despite normal HbA1C. Dyslipidaemia was seen in 66.7% of these adolescents. Obstructive sleep apnoea was confirmed in 26.7% of CYP. Prior to treatment, the adolescents had a low physical and psychosocial QoL scores with a mean score of 52.2 (±16.2) and 59.7 (±20.1) respectively. Semaglutide resulted in improvements in body weight, BMI, and BMI standard deviation scores within 4 weeks of treatment initiation. There was a significant reduction in the body fat mass compared to baseline. All patients tolerated the treatment well and no adverse effects were reported.

Conclusion: We report, for the first time, the impact of semaglutide on glycaemic status (using CGM) and quality of life measures in CYP with obesity. This study also shows good tolerance and positive effects of semaglutide on body weight and body composition within a short period of treatment, during dose titration.