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Meta-Analysis
. 2021 Jun;22(6):e13177.
doi: 10.1111/obr.13177. Epub 2020 Dec 22.

GLP-1 agonists for obesity and type 2 diabetes in children: Systematic review and meta-analysis

Karan R Chadda  1 , Tuck Seng Cheng  2 , Ken K Ong  1   2
Affiliations
Meta-Analysis

GLP-1 agonists for obesity and type 2 diabetes in children: Systematic review and meta-analysis

Karan R Chadda et al. Obes Rev. 2021 Jun.

Abstract

Pharmacological options for management of obesity and type 2 diabetes mellitus (T2DM) in children are limited. We aimed to synthesize published randomized controlled trial (RCT) evidence on the efficacy of glucagon-like peptide-1 (GLP-1) agonists in T2DM, pre-diabetes, and obesity in children aged <18 years. Inclusion criteria were RCTs of any GLP-1 agonist, solely or in conjunction with other drugs, for the treatment of obesity, pre-diabetes, and/or T2DM in children aged <18 years old. Nine studies met the inclusion criteria (two for T2DM, one for pre-diabetes, and six for obesity without diabetes). In total, 286 children were allocated to GLP-1 agonist therapy. Compared with controls, GLP-1 agonist therapy reduced HbA1c by -0.30% (95% confidence interval [CI] -0.57, -0.04) with a larger effect in children with (pre-)diabetes (-0.72%; 95% CI -1.17, -0.28; three studies) than in children with obesity (-0.08%; 95% CI -0.13, -0.02; four studies). Conversely, GLP-1 agonist therapy reduced body weight more in children with obesity (-2.74 kg; 95% CI -3.77, -1.70; six studies) than in children with T2DM (-0.97 kg; 95% CI -2.01, 0.08; two studies). Adverse effects included gastrointestinal symptoms and minor hypoglycemic episodes, but not severe hypoglycemia. GLP-1 agonists are efficacious in treating children with obesity and/or T2DM. Effect sizes are comparable with those reported in adults.

Keywords: glucagon-like peptide-1; obesity; pediatric; type 2 diabetes.

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