BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: In conclusion, in children and adolescents with obesity, GLP-1 receptor agonists significantly reduced BMI z-score, waist circumference and body weight.
IMPACT: 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.
