Predictors of Weight-Loss Response with Glucagon-Like Peptide-1 Receptor Agonist Treatment among Adolescents with Severe Obesity

Abstract

Background

In two previous, separate clinical trials, we demonstrated significant reductions in BMI with exenatide in adolescents with severe obesity. In the present study, we pooled data from these near identical trials to evaluate factors that may predict BMI reduction at 3 months.

Methods

Data from 32 patients (mean age 14.3±2.2 years; 69% female; mean BMI 39.8±5.8 kg/m ²) were included. Exenatide treatment consisted of 5 mcg twice daily for 1 month, followed by an increase to 10 mcg twice daily for 2 additional months. Predictor variables included baseline BMI, BMI percent change at 1 month, incidence of nausea/vomiting, and baseline appetite and satiety measures. Treatment effects of percent change in BMI from baseline were estimated within predictor subgroups using generalized estimating equations with exchangeable working correlation and robust variance estimation for confidence intervals and P-values to account for paired observations.

Results

The pooled data treatment effect on absolute BMI at 3 months was −3.42% [95% CI: −5.41%, −1.42%] compared to placebo. Within treated participants, appetite at baseline (treatment effect in high [−4.28%] vs. low [1.02%], p=0.028) and sex (treatment effect in female [−4.78%] vs. male [0.76%], p=0.007) were significant predictors of change in BMI at 3 months. Baseline BMI, BMI percent change at 1 month, age, incidence of nausea, vomiting, or other gastrointestinal symptoms, and satiety scores did not predict 3 month responses.

Conclusions

Sex and measures of appetite may serve as useful predictors of glucagon-like peptide-1 receptor agonist treatment response among adolescents with severe obesity.