Pharmacological interventions for the management of children and adolescents living with obesity—An update of a Cochrane systematic review with meta‐analyses
Authors' conclusion
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.
Study context
- Population
- Children and adolescents <19 years living with obesity; RCTs ≥6 months; age 8.8–16.3 years; Body mass index (BMI) 26.2–41.7 kg/m²
- Participants
- 4,331 children35 trials
- Comparison
- Anti-obesity medication vs comparator
- Outcome
- BMI
- Follow-up
- 6-24 months
Methodological detailsCochrane review update, Searches 1/1/16-17/3/23: Cochrane CENTRAL, MEDLINE, ClinicalTrials.gov, WHO ICTRP, Screening, extraction and quality assessment in duplicate, independently
- Cochrane review update
- Searches 1/1/16-17/3/23: Cochrane CENTRAL, MEDLINE, ClinicalTrials.gov, WHO ICTRP
- Screening, extraction and quality assessment in duplicate, independently
Pooled result
As reported in the abstract
BMI reduction with anti-obesity medication
−1.71 units
95% CI −2.27 to −1.14
Range between individual drugs
−0.8 to −5.9 units
Heterogeneity explained by drug type
≈44%
Further pooled results
BMI with semaglutide
- Largest BMI reduction, semaglutide
- −5.88 kg/m² (95% CI: −6.99 to −4.77, N = 201)
- Moderate certainty evidence
95th percentile BMI
- Reduction in 95th percentile BMI
- −11.88 percentage points (95% CI: −18.43 to −5.30, N = 668)
- Low certainty evidence
Quality of life
- Trend towards improved quality of life
Safety
| Outcome | Medication | Comparator | RR (95% CI) | |
|---|---|---|---|---|
| Medication dose adjustmentsI2 = 15% · regardless of approval status | 10.6% | 1.7% | 3.74 (1.51–9.26) | |
| 0.10.31310Relative risk (log scale) |
Serious AEs and discontinuation due to AEs
- Serious adverse events and discontinuation due to adverse events did not differ between medications and comparators
Original publication
Pharmacological interventions for the management of children and adolescents living with obesity—An update of a Cochrane systematic review with meta‐analyses. Pediatr Obes. Published 7 March 2024. doi:10.
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