Endocrine Abstracts

Background: Liraglutide is a glucagon-like peptide analogue recently approved for use in children and young people for treating obesity. It is recommended for use within multidisciplinary weight management services, alongside dietetic and lifestyle interventions, in children over 12 years with severe obesity.

Aim: To describe our experiences of using liraglutide in a tier 3 paediatric obesity service in a patient cohort who had previously failed to successfully lose weight despite multidisciplinary team (MDT) input.

Methods: Liraglutide was started at 0.6 mg and increased weekly as tolerated up to a maximum dose of 3.0 mg. BMI was recorded 3- and 6-months after commencing liraglutide.

Results: 37 patients commenced liraglutide. Patients with treatment duration over 3 months were included in outcome analysis (23 patients; 12 female; age range 10.4-17.9 years). BMI-SDS before treatment ranged from +2.58 to +4.71 (mean +3.69). 7/23 patients had complications of obesity: hypertension (2), non-alcoholic fatty liver disease (3) and obstructive sleep apnoea (2). 7/23 patients had neurodevelopmental problems: autism (2), attention-deficit hyperactivity disorder (3) and learning difficulties (2). 22/23 (96%) patients had continued liraglutide at their 3-month review; one stopped due to pre-existing mental health problems. Gastro-intestinal side effects were frequent but mostly felt to be tolerable. 22/23 patients escalated to 3.0 mg daily but 1 remained on 1.8 mg due to significant nausea. 20/23 (87%) patients had lost weight at 3-month review (mean BMI reduction 4%; BMI-SDS change -0.13). Five patients (5/23) who had received 6 months treatment demonstrated further sustained BMI decrease (mean BMI reduction 6%; BMI-SDS change -0.24).

Discussion: These data represent encouraging results for the effectiveness and tolerability of liraglutide in adolescent patients who have not previously lost weight despite MDT input. This is promising as liraglutide is likely to become more widely used with the expansion of paediatric obesity services through the NHS-England funded complications of excess weight (CEW) clinics. Further follow-up is needed into longer-term outcomes in these patients.