Efficacy and safety of liraglutide and semaglutide in obese children and adolescents: a systematic review

Objective. To evaluate efficacy and safety of glucagon-like peptide-1 receptor agonists (liraglutide and semaglutide) for the treatment of obesity in children and adolescents. Material and methods. A systematic review was conducted in accordance with the PRISMA 2020 recommendations. We searched publications in PubMed, eLibrary and ClinicalTrials.gov databases, as well as in registers of clinical trials. Inclusion criteria were based on PICO principles: population — patients <18 years with primary obesity; intervention — therapy with liraglutide or semaglutide; comparison — placebo or standard therapy; outcomes — changes in anthropometric parameters and safety profile. Risk of systematic errors was assessed using the Cochrane RoB 2.0 tool. Results. Final analysis included 5 randomized, double-blind, placebo-controlled trials (n=579). Ther was high effectiveness of semaglutide (16.1%) in reducing body mass index after 68-week therapy. Liraglutide provides a maximum reduction in body mass index by 5.8%. Undesirable phenomena included mild-to-moderate transient gastrointestinal disorders (nausea, vomiting, diarrhea). There were several cases of serious adverse events, including those associated with gallstone disease, after semaglutide therapy. Conclusion. Liraglutide and semaglutide demonstrate significant superiority over placebo in reducing body weight and body mass index in obese children and adolescents. Safety profile of these drugs corresponds to available data in adults, but requires careful monitoring, especially with regard to gastrointestinal disorders. These results substantiate therapy in pediatric practice with careful assessment of the benefit-risk ratio.