ESPE Abstracts

Background: Childhood obesity, defined as having a BMI ³95th percentile for age and gender, can have serious consequences, hence; new treatments are needed. Liraglutide, a glucagon-like peptide-1 hormone, is the first FDA-approved therapy for adolescents’ obesity in over a decade. This study aim ed to evaluate the efficacy of liraglutide for weight loss and other metabolic parameters in children with obesity in Saudi Arabia.

Methods: A retrospective cohort study was conducted at King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia (January 2019 to December 2022). All patients had simple obesity and we excluded patients with syndromic obesity. They all received intensive education and coached for lifestyle modifications. Data was then collected from patients’ electronic records of Lifestyle alone (Lifestyle) group Vs Lifestyle and Liraglutide (Liraglutide) group. Comparison of two repeated measures was performed in the two matched groups using paired t-tests between measurements obtained at T1, T2 (6-9), and T3 (9-12) months simultaneously. Data included changes in BMI, A1c and other metabolic markers. Linear mixed models were used to perform regression analysis using SAS 9.4 to determine the effect of treatment status overtime with a significance level of a P-value <0.05.

Results: Data collected from 138 patients (n = 69 in each group) with means of BMI (35.78 kg/m²) and HbA1c (5.85%). BMI was reduced significantly in T1-T3 in Liraglutide group. Notably, within the liraglutide group, BMI declined in T1-T3 by 0.48 kg/m² (P = 0.003). An interaction effect (P = 0.027) suggested a treatment impact until the first follow-up, which wasn't sustained thereafter. Lifestyle group exhibited no significant changes in biomarkers across T1-T2-T3 period. Although there was no significant difference in the interaction between the two groups in the overall BMI changes (P = 0.089), the liraglutide group showed significant reductions in the BMI (T1-T2 (P = 0.0057), T1-T3 (0.010), Total cholesterol (T1-T2 (0.023) and LDL (T1-T2, T1-T3 (P = 0.05) means over time. While treatment showed no overall effect on HbA1c change (P = 0.218), liraglutide patients exhibited a 0.13% decline in T1-T3 period (P = 0.004). Regression analyses revealed a reduction in total cholesterol and Alkaline phosphatase levels over time in the Liraglutide group (P <0.05). These findings highlight the differential effects of liraglutide treatment versus lifestyle alone on different metabolic biomarkers, especially BMI, albeit with some variability in its sustainable effect.

Conclusion: Liraglutide besides lifestyle interventions is an effective treatment that reduces the BMI in obese adolescents in the first 6-9 months. However, continuous lifestyle intervention has a key role in sustainability.