Новости от лечението на затлъстяване при тийнеджъри

SAN FRANCISCO — Few medical therapies have been approved to treat adolescents with obesity but that is about to change, and a next step will be to test endoscopic devices in teens, two experts have predicted here at the American Diabetes Association (ADA) 2019 Scientific Sessions.

“I think there is a place for medication in adolescent obesity,” but current options “continue to remain limited,” Daniel S. Hsia, MD, Pennington Biomedical Research Center, Baton Rouge, Louisiana, summarized to Medscape Medical News following his presentation here.

He had explained that only orlistat and phentermine are approved by the US Food and Drug Administration (FDA) to treat adolescents with obesity, whereas nine medical therapies have been approved for weight loss in adults.

“I think that off-label use is going to continue until we have more pediatric adolescent data and we have FDA approvals for [anti-obesity] medications” for adolescents, Hsia predicted.

However, “there is hope on the horizon,” he added, “for the specific [obese young] populations that need medical therapy that may not fit so much in bariatric surgery or may not have had quite the benefit from lifestyle modification.”

“Liraglutide (Saxenda, Novo Nordisk) [trial] results [in teens] will probably be available early next year,” Hsia expects. “That’s probably the one that will be the next one up,” to be approved for treating adolescents with obesity, he said.

A randomized controlled trial of lorcaserin (Belviq, Eisai) in adolescents with obesity is ongoing and still open for enrolment, he noted, and there is a phase 4 trial that is just starting for phentermine/topiramate (Qsymia, Vivus).

During the same session, Andrew C. Storm, MD, Mayo Clinic, Rochester, Minnesota, summarized the growing number of endoscopic devices that are approved or being tested for weight loss.

The approvals have happened “in the past 3 to 4 years and three to five have FDA approval trials ongoing or starting within the summer [in adults], so I expect to see — if not this year then definitely in the next year or two — quite a number of endoscopic therapies for obesity and metabolic disease available,” he told Medscape Medical News.

“It is pretty clear that obesity from childhood carries into adulthood,” Storm added. “Given that these [devices] are so safe and have such reasonable impacts in obesity upfront, I think the next step will be studying them in young adults.”

“It’s very exciting because there are new and evolving therapies in the field of the treatment of obesity [for adolescents],” session chair Amy E. Rothberg, MD, PhD, University of Michigan, Ann Arbor, told Medscape Medical News.

“It’s going to reshape the landscape and practitioners will be more comfortable prescribing these therapies,” she predicted.

“Stay tuned, but there are probably going to be double what we have in terms of pharmacotherapy and combination pharmacotherapy in the future” for treating adolescents, she said.

Asked if this will this make a dent in the obesity rate in young people, she replied: “I’m optimistic, so I certainly hope so.”

Only Orlistat and Phentermine Approved for Obese Teens

Endocrine Society guidelines published in 2017 (J Clin Endocrinol Metab. 2017;102:709-757) specify that pharmacotherapy with FDA-approved therapies can be suggested for adolescents who are obese if a formal lifestyle modification program fails to limit weight gain or improve comorbidities, Hsia noted.

 

Източник: https://www.medscape.com