Efficacy Of GLP-1 Receptor Agonists in the Management of Hyperphagia, Severe Obesity, and Liver Steatosis/Fibrosis Indices in Prader Willi Syndrome: Two Case Reports

Hyperphagia and severe obesity resistant to dietary interventions represent common clinical features of Prader Willi Syndrome (PWS).Currently, there are no drugs approved for the treatment of hyperphagia in PWS patients.Liraglutide and semaglutide are glucagon-like peptide-1 receptor agonist (GLP-1-RA) approved for the treatment of non-syndromic obesity.Here we describe the cases of two young female patients with PWS and without type 2 diabetes, resistant to previous weight loss attempts, who were sequentially treated with liraglutide and semaglutide, associated with a mild hypocaloric diet.Hyperphagia, assessed by Hyperphagia Questionnaire (HQ), quality of life (QoL), assessed by The Short Form-36 (SF-36), anthropometric measurements, metabolic profile, and liver steatosis/fibrosis indices, were evaluated at baseline, after the treatment with liraglutide, and after subsequent treatment with semaglutide.In our cases, the sequential treatment with liraglutide and semaglutide, in addition to a mild hypocaloric diet, led to improvements in hyperphagia, excess body weight, insulin resistance, and indices of hepatic steatosis/ fibrosis, which were not previously achieved with diet alone.These results support the use of GLP-1 RAs as valid therapeutic strategy for managing hyperphagia and weight loss in patients with PWS.