The experience of using liraglutide in adolescents with exogenous constitutional obesity. Analysis of clinical outcomes

Background. The prevalence of childhood obesity is increasing every year. If non-drug measures aimed at reducing body weight are ineffective, it is possible to use drug therapy with an analog of a glucagon-like type 1 peptide, liraglutide. Аim. To evaluate the effectiveness of therapy and frequency of adverse reactions in obese adolescents treated with liraglutide. Matherials and methods. 17 adolescents aged 12–17 years with exogenous constitutional obesity were examined with an assessment of physical development indicators (BMI, SDS BMI), laboratory parameters of fat (cholesterol and its fractions, triglycerides) and carbohydrate (glucose, insulin) metabolism. Liraglutide therapy was performed at a starting dose of 0.6 mg daily, dose titration according to the instructions, and the course of therapy was 12 months. Repeated examination after 1, 4 and 12 months. Statistical data processing – Statistics version 7.0. Results. The initial SDS BMI in patients was +3.07 [2.9; 3.39]. After a month, SDS BMI decreased to 2.9 [2.5; 3.17]. Against the background of therapy, patients most often complained of functional disorders of the gastrointestinal tract: by the end of the first month, in 35% of cases, by the 4th month, the frequency of side effects decreased to 23.5%. In the future, the complaints were spontaneously stopped and did not resume. During the entire follow-up period, 6 patients stopped therapy ahead of schedule: 2 patients due to side effects or individual intolerance to the medication, 2 patients due to dissatisfaction with therapy, 1 patient due to achieving target weight values and 1 patient due to fear of side effects. In patients who successfully completed the course of therapy (n = 11), there was a significant decrease in SDS BMI by 0.73 [0.4; 0.86] and an improvement in metabolic status. By the end of the course of therapy, 36% (4) of patients had been diagnosed with obesity, 9% (1) of patients had a reduction in the degree of obesity to the first, 27.5% (3) to the second, and 27.5% (3) retained the third degree. Conclusion. liraglutide therapy is an effective direction of drug correction of obesity in adolescents. Severe dyspeptic disorders reduce the effectiveness of therapy, which requires an in-depth examination of the patient and correction of existing background conditions before prescribing the drug.