Torbahn, G, Jones, A, Griffiths, A, Matu, J, Metzendorf, M-I, Ells, LJ, Gartlehner, G, Kelly, AS, Weghuber, D and Brown, T (2024) Pharmacological interventions for the management of children and adolescents living with obesity - An update of a Cochrane systematic review with meta-analyses. Pediatric Obesity. pp. 1-19.

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Abstract

Importance The effectiveness of anti-obesity medications for children and adolescents is unclear. Objective To update the evidence on the benefits and harms of anti-obesity medication. Data Sources Cochrane CENTRAL, MEDLINE, ClinicalTrials.gov and WHO ICTRP (1/1/16–17/3/23). Study Selection Randomized controlled trials ≥6 months in people <19 years living with obesity. Data Extraction and Synthesis Screening, data extraction and quality assessment conducted in duplicate, independently. Main Outcomes and Measures Body mass index (BMI): 95th percentile BMI, adverse events and quality of life. Results Thirty-five trials (N = 4331), follow-up: 6–24 months; age: 8.8–16.3 years; BMI: 26.2–41.7 kg/m2. Moderate certainty evidence demonstrated a −1.71 (95% confidence interval [CI]: −2.27 to −1.14)-unit BMI reduction, ranging from −0.8 to −5.9 units between individual drugs with semaglutide producing the largest reduction of −5.88 kg/m2 (95% CI: −6.99 to −4.77, N = 201). Drug type explained ~44% of heterogeneity. Low certainty evidence demonstrated reduction in 95th percentile BMI: −11.88 percentage points (95% CI: −18.43 to −5.30, N = 668). Serious adverse events and study discontinuation due to adverse events did not differ between medications and comparators, but medication dose adjustments were higher compared to comparator (10.6% vs 1.7%; RR = 3.74 [95% CI: 1.51 to 9.26], I2 = 15%), regardless of approval status. There was a trend towards improved quality of life. Evidence gaps exist for children, psychosocial outcomes, comorbidities and weight loss maintenance. Conclusions and Relevance Anti-obesity medications in addition to behaviour change improve BMI but may require dose adjustment, with 1 in 100 adolescents experiencing a serious adverse event.

Item Type:	Article
Uncontrolled Keywords:	adolescents; adverse events; anti-obesity medication; body mass index; meta-analysis; obesity; 11 Medical and Health Sciences; Endocrinology & Metabolism
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RS Pharmacy and materia medica
Divisions:	Psychology (from Sep 2019)
Publisher:	Wiley
SWORD Depositor:	A Symplectic
Date Deposited:	13 Mar 2024 09:24
Last Modified:	13 Mar 2024 09:30
DOI or ID number:	10.1111/ijpo.13113
URI:	https://researchonline.ljmu.ac.uk/id/eprint/22793

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