Comparison of weight loss and adverse events of obesity drugs in children and adolescents: a systematic review and meta-analysis

ABSTRACT

Background

The global incidence of childhood obesity is increasing. Currently, there are only few established drugs for treating adolescent obesity. Randomized clinical trials (RCTs) comparing pharmacological interventions in children with obesity are scarce; therefore, we aimed to analyze the relative efficacy and adverse reactions of these drugs and compare the effects of each drug on body mass index (BMI).

Research design and methods

This meta-analysis focused on the slimming effect, safety, and correlation of metformin, orlistat, exenatide, liraglutide, and topiramate in children with obesity. Several international databases were searched and clinical trials on the treatment of obesity in children in which the drug was administered for ≥ 6 months were included. Changes in BMI before and after treatment were analyzed using a Bayes framework, and the surface under the cumulative ranking was calculated.

Results

Of 2102 relevant articles retrieved, 21 RCTs were included in the study. Compared to other drugs, liraglutide reduced BMI the most in children with obesity. However, it was most associated with drug withdrawal due to adverse events while topiramate was least.

Conclusions

Liraglutide had a higher probability of achieving clinically significant weight loss compared with other drugs while topiramate was superior in safety.

KEYWORDS:

• Adolescent
• anti-obesity agents
• child
• meta-analysis
• obesity
• weight loss

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed receiving research grants from Novo Nordisk Foundation and Novo Nordisk. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

G Zhao and F Wu: study concept and design; G Zhao and Q Zhang: acquisition, analysis, or interpretation of data; Q Zhang: drafting of the manuscript; G Zhao and Y Xie: statistical analysis; H Liu: administrative, technical, or material support; S Yin: study supervision; all authors: critical revision of the manuscript for important intellectual content.

Supplementary material

Supplemental data for this article can be accessed here