GLP-1 receptor agonists for the treatment of obesity in children and adolescents: a meta-analysis of randomized controlled trials.

Abstract

Glucagon-like peptide-1 (GLP-1) receptor agonists were recently approved for obesity treatment in children 12-17 years by both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA). However, their effectiveness in younger pediatric patients remains uncertain. We systematically searched PubMed, Embase and Cochrane for randomized controlled trials (RCTs) comparing GLP-1 receptor agonists versus. placebo in children and adolescents. Continuous outcomes were computed with mean differences (MD) and 95% confidence intervals (CI) with random-effect models. This meta-analysis included 11 RCTs with 1024 patients with obesity, aged from 6 to 19 years old. Compared with placebo, GLP-1 agonists significantly decreased body weight (MD -4.32 kg; 95% CI -7.02 to -1.63 kg; p < 0.01), BMI z-score (MD -0.28; 95% CI -0.45 to -0.1; p < 0.01) and waist circumference (MD -3.84 cm; 95% CI -6.97 to -0.70 cm; p = 0.02) in this population. An analysis of patients <12 years old showed that GLP-1 receptor agonists significantly decreased BMI z-score (MD -0.33; 95% CI -0.47 to -0.20; p < 0.01). Gastrointestinal symptoms were the most frequent adverse event (RR 1.52; 95% CI 1.09 to 2.12; p < 0.01). In conclusion, in children and adolescents with obesity, GLP-1 receptor agonists significantly reduced BMI z-score, waist circumference and body weight. The importance of this article is based on the limited treatment options for childhood obesity, particularly in children under the age of 12. No meta-analysis with a sample size of children under the age of 12 comparable to this one has been conducted thus far. For now, GLP-1 analogs are only approved for children over the age of 12; however, the study suggests that children under 12 may also benefit from their use.