Safety and efficacy of glucagon-like peptide-1 receptor agonists in children and adolescents with obesity: A meta-analysis

Ryan, Paul M.; Seltzer, Sean; Hayward, Nathaniel E.; Avelar Rodriguez, David; Sless, Ryan T.; Hawkes, Colin P.

Safety and efficacy of glucagon-like peptide-1 receptor agonists in children and adolescents with obesity: A meta-analysis

dc.contributor.author	Ryan, Paul M.
dc.contributor.author	Seltzer, Sean
dc.contributor.author	Hayward, Nathaniel E.
dc.contributor.author	Avelar Rodriguez, David
dc.contributor.author	Sless, Ryan T.
dc.contributor.author	Hawkes, Colin P.
dc.date.accessioned	2021-11-29T13:53:26Z
dc.date.available	2021-11-29T13:53:26Z
dc.date.issued	2021-05-11
dc.date.updated	2021-11-29T13:39:59Z
dc.description.abstract	To determine the weight, body mass index (BMI), cardiometabolic, and gastrointestinal effects of glucagon-like peptide-1 (GLP-1) receptor agonists in children with obesity. Study design: Web of Science, PubMed/MEDLINE, and Scopus databases from 01/01/1994-01/01/2021 for randomized control trials examining the weight, BMI, cardiometabolic, or gastrointestinal effects of GLP-1 receptor agonists in children and adolescents with obesity. Data were extracted by 2 independent surveyors and a random effects model was applied to meta-analyze generic inverse variance outcomes. Primary outcomes were related to weight and cardiometabolic profile, and secondary outcomes of interest were gastrointestinal-related treatment-emergent adverse events. Results: Nine studies involving 574 participants were identified, of which 3 involved exenatide and 6 involved liraglutide. GLP-1 receptor agonists use caused a modest reduction in body weight (mean difference [MD] -1.50 [-2.50,-0.50] kg, I2 64%), BMI (MD -1.24 [-1.71,-0.77] kg/m2, I2 0%), and BMI z score (MD -0.14 [-0.23,-0.06], I2 43%). Glycemic control was improved in children with proven insulin resistance (glycated hemoglobin A1c MD -1.05 [-1.93,-0.18] %, I2 76%). Although no lipid profile improvements were noted, a modest decrease in systolic blood pressure was detected (MD -2.30 [-4.11,-0.49] mm Hg; I2 0%). Finally, analysis of gastrointestinal-related treatment-emergent adverse events revealed an increased risk of nausea (risk ratio 2.11 [1.44, 3.09]; I2 0%), without significant increases in other gastrointestinal symptoms. Conclusions: This meta-analysis indicates that GLP-1 receptor agonists are safe and effective in modestly reducing weight, BMI, glycated hemoglobin A1c, and systolic blood pressure in children and adolescents with obesity in a clinical setting, albeit with increased rates of nausea.	en
dc.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.citation	Ryan, P. M., Seltzer, S., Hayward, N. E., Avelar Rodriguez, D., Sless, R. T. and Hawkes, C. P. (2021) 'Safety and efficacy of glucagon-like peptide-1 receptor agonists in children and adolescents with obesity: A meta-analysis', Journal of Pediatrics, 236 , pp. 137-147. doi: 10.1016/j.jpeds.2021.05.009	en
dc.identifier.doi	10.1016/j.jpeds.2021.05.009	en
dc.identifier.endpage	147	en
dc.identifier.issn	1097-6833
dc.identifier.issn	0022-3476
dc.identifier.journaltitle	Journal of Pediatrics	en
dc.identifier.startpage	137	en
dc.identifier.uri	https://hdl.handle.net/10468/12281
dc.identifier.volume	236	en
dc.language.iso	en	en
dc.publisher	Elsevier B. V.	en
dc.rights	© 2021, the Authors. Published by Elsevier inc. This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.	en
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/	en
dc.subject	Pediatric obesity	en
dc.subject	Incretin	en
dc.subject	GLP-1	en
dc.title	Safety and efficacy of glucagon-like peptide-1 receptor agonists in children and adolescents with obesity: A meta-analysis	en
dc.type	Article (peer-reviewed)	en