Peer-reviewed article
Efficacy and safety of GLP-1 receptor agonists for adolescents and children with obesity: a meta-analysis of randomized controlled trials.
Chen Q, Liu H, Xu J, Zhou Y, Ma J ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This meta-analysis evaluates GLP-1 receptor agonists (medications including liraglutide, semaglutide, and exenatide) as a treatment for obesity in children and adolescents. The analysis of 14 randomized controlled trials with 1,349 participants found that these medications significantly reduced body weight, BMI, and blood sugar levels compared to placebo. Gastrointestinal side effects were more common in the medication group, but the overall safety profile was acceptable.
Key points
- GLP-1 receptor agonists reduced body weight by an average of 4.5 kg more than placebo
- BMI was reduced by an average of 1.65 units more than placebo
- HbA1c and fasting blood glucose levels showed statistically significant improvements
- Gastrointestinal adverse events were more frequent in the treatment group
- No significant difference in serious adverse events between treatment and placebo groups
Limitations
This is a meta-analysis of existing trials and does not evaluate long-term health outcomes, quality of life, or how these medications affect children's development and participation in normal activities. The analysis cannot determine optimal dosing, ideal patient selection criteria, or comparative effectiveness versus lifestyle interventions.
Abstract
OBJECTIVE: To evaluate the efficacy and safety of glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of obesity among children and adolescents. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared GLP-1 receptor agonists with placebo in children and adolescents with obesity. Literature retrieval, study selection, and data extraction were performed according to the PRISMA guidelines. Pooled mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using RevMan 5.3 software. RESULTS: Fourteen RCTs comprising 1349 participants were included, with 810 patients assigned to GLP-1 receptor agonist treatment (liraglutide [n = 317], exenatide [n = 125], semaglutide [n = 265], dulaglutide [n = 103]) and 539 to placebo. Compared with placebo, GLP-1 receptor agonists significantly reduced body weight (MD = -4.50; 95% CI: -6.40 to -2.60; P < 0.0001), body mass index (BMI) (MD = -1.65; 95% CI: -2.05 to -1.26; P < 0.00001), hemoglobin A1c (HbA1c) (MD = -0.34%; 95% CI: -0.63 to -0.05; P = 0.02), and fasting blood glucose (MD = -0.21; 95% CI: -0.41 to -0.01; P = 0.04). The overall incidence of adverse events was similar between groups, with no significant difference in serious adverse events. However, gastrointestinal adverse events were more frequent in the GLP-1 receptor agonist group. CONCLUSIONS: GLP-1 receptor agonists are effective in reducing weight and improving glycemic parameters in children and adolescents with obesity, with an acceptable safety profile. Variations in efficacy may exist among different agents within the drug class. CLINICAL TRIAL NUMBER: Not applicable.