TY - JOUR
T1 - Experiences with Glucagon-Like Peptide-1 Receptor Agonist in Children with Acquired Hypothalamic Obesity
AU - van Schaik, Jiska
AU - Begijn, Dominique G A
AU - van Iersel, Laura
AU - Vergeer, Yvonne
AU - Hoving, Eelco W
AU - Peeters, Babette
AU - van Santen, Hanneke M
N1 - Funding Information:
The off-label use of the GLP-1 receptor agonist (exenatide) was supported by Wilhelmina Children’s Hospital, Utrecht. We want to thank Dr. P. Zuithoff for statistical support.
Funding Information:
The off-label use of the GLP-1 receptor agonist (exenatide) was supported by Wilhelmina Children?s Hospital, Utrecht. We want to thank Dr. P. Zuithoff for statistical support.
Publisher Copyright:
© 2020
PY - 2020/10/1
Y1 - 2020/10/1
N2 - OBJECTIVE: Hypothalamic obesity (HO) in children after treatment for a tumor in the suprasellar region has severe implications. Previous studies have shown various effects of glucagon-like peptide-1 (GLP-1) receptor agonist in acquired HO, but in adults only. We present our experience of GLP-1 receptor agonist (exenatide) treatment during a 1-year period on body mass index (BMI) in children with acquired HO.PATIENTS AND METHODS: Children with severe weight gain after treatment for suprasellar tumor were given 2 mg exenatide weekly for a 12-month period. All had undergone previous dietary intervention. BMI standard deviation score (SDS), weight change, and adverse effects were assessed.RESULTS: Five children with a mean age of 15.4 years (range 13-18) and a mean follow-up time of 8.4 years (mean age of 7.0 years at the time of brain tumor diagnosis) were treated with GLP-1 receptor agonist. After 1 year, BMI SDS or absolute weight had not changed significantly compared to the period without treatment (BMI SDS change +0.005, 95% CI -0.07 to 0.08, p = 0.89, and absolute weight change +1.5 kg, 95% CI -0.08 to 3.1, p = 0.061). Only 1 patient experienced weight loss after 1 year (-5.4 kg, BMI SDS -0.33). All patients experienced mild side effects, such as injection pain or nausea, and 2 patients stopped treatment upon their own request after 8 and 11 months, respectively.CONCLUSIONS: In this small cohort, we found little effect of GLP-1 receptor agonist in the treatment for acquired HO. Future research should focus on the prevention of HO or, if prevention is not possible, on alternative, individualized interventions.
AB - OBJECTIVE: Hypothalamic obesity (HO) in children after treatment for a tumor in the suprasellar region has severe implications. Previous studies have shown various effects of glucagon-like peptide-1 (GLP-1) receptor agonist in acquired HO, but in adults only. We present our experience of GLP-1 receptor agonist (exenatide) treatment during a 1-year period on body mass index (BMI) in children with acquired HO.PATIENTS AND METHODS: Children with severe weight gain after treatment for suprasellar tumor were given 2 mg exenatide weekly for a 12-month period. All had undergone previous dietary intervention. BMI standard deviation score (SDS), weight change, and adverse effects were assessed.RESULTS: Five children with a mean age of 15.4 years (range 13-18) and a mean follow-up time of 8.4 years (mean age of 7.0 years at the time of brain tumor diagnosis) were treated with GLP-1 receptor agonist. After 1 year, BMI SDS or absolute weight had not changed significantly compared to the period without treatment (BMI SDS change +0.005, 95% CI -0.07 to 0.08, p = 0.89, and absolute weight change +1.5 kg, 95% CI -0.08 to 3.1, p = 0.061). Only 1 patient experienced weight loss after 1 year (-5.4 kg, BMI SDS -0.33). All patients experienced mild side effects, such as injection pain or nausea, and 2 patients stopped treatment upon their own request after 8 and 11 months, respectively.CONCLUSIONS: In this small cohort, we found little effect of GLP-1 receptor agonist in the treatment for acquired HO. Future research should focus on the prevention of HO or, if prevention is not possible, on alternative, individualized interventions.
KW - Glucagon-like peptide-1 receptor agonist
KW - Hypothalamic dysfunction
KW - Obesity
KW - Suprasellar tumor
UR - http://www.scopus.com/inward/record.url?scp=85090308958&partnerID=8YFLogxK
U2 - 10.1159/000509302
DO - 10.1159/000509302
M3 - Article
C2 - 32781455
SN - 1662-4025
VL - 13
SP - 361
EP - 370
JO - Obesity Facts
JF - Obesity Facts
IS - 4
ER -