Once-Weekly Semaglutide in Adolescents with Obesity

Daniel Weghuber, Timothy Barrett, Margarita Barrientos-Pérez, Inge Gies, Dan Hesse, Ole K. Jeppesen, Aaron S. Kelly, Lucy D. Mastrandrea, Rasmus Sørrig, Silva Arslanian

Research output: Contribution to journalArticlepeer-review

143 Scopus citations

Abstract

Background A once-weekly, 2.4-mg dose of subcutaneous semaglutide, a glucagon-like peptide-1 receptor agonist, is used to treat obesity in adults, but assessment of the drug in adolescents has been lacking. Methods In this double-blind, parallel-group, randomized, placebo-controlled trial, we enrolled adolescents (12 to <18 years of age) with obesity (a body-mass index [BMI] in the 95th percentile or higher) or with overweight (a BMI in the 85th percentile or higher) and at least one weight-related coexisting condition. Participants were randomly assigned in a 2:1 ratio to receive once-weekly subcutaneous semaglutide (at a dose of 2.4 mg) or placebo for 68 weeks, plus lifestyle intervention. The primary end point was the percentage change in BMI from baseline to week 68; the secondary confirmatory end point was weight loss of at least 5% at week 68. Results A total of 201 participants underwent randomization, and 180 (90%) completed treatment. All but one of the participants had obesity. The mean change in BMI from baseline to week 68 was -16.1% with semaglutide and 0.6% with placebo (estimated difference, -16.7 percentage points; 95% confidence interval [CI], -20.3 to -13.2; P<0.001). At week 68, a total of 95 of 131 participants (73%) in the semaglutide group had weight loss of 5% or more, as compared with 11 of 62 participants (18%) in the placebo group (estimated odds ratio, 14.0; 95% CI, 6.3 to 31.0; P<0.001). Reductions in body weight and improvement with respect to cardiometabolic risk factors (waist circumference and levels of glycated hemoglobin, lipids [except high-density lipoprotein cholesterol], and alanine aminotransferase) were greater with semaglutide than with placebo. The incidence of gastrointestinal adverse events was greater with semaglutide than with placebo (62% vs. 42%). Five participants (4%) in the semaglutide group and no participants in the placebo group had cholelithiasis. Serious adverse events were reported in 15 of 133 participants (11%) in the semaglutide group and in 6 of 67 participants (9%) in the placebo group. Conclusions Among adolescents with obesity, once-weekly treatment with a 2.4-mg dose of semaglutide plus lifestyle intervention resulted in a greater reduction in BMI than lifestyle intervention alone. (Funded by Novo Nordisk; STEP TEENS ClinicalTrials.gov number, NCT04102189.)

Original languageEnglish (US)
Pages (from-to)2245-2257
Number of pages13
JournalNew England Journal of Medicine
Volume387
Issue number24
DOIs
StatePublished - Dec 15 2022

Bibliographical note

Funding Information:
Supported by Novo Nordisk .

Funding Information:
The Funded by Novo Nordisk; STEP TEENS ClinicalTrials.gov number, NCT04102189

Publisher Copyright:
© 2022 Massachusetts Medical Society.

Keywords

  • Adolescent Medicine
  • Diet/Nutrition
  • Diet/Nutrition (Pediatrics)
  • Endocrinology
  • Gastroenterology
  • Obesity
  • Pediatrics

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Journal Article
  • Research Support, Non-U.S. Gov't

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