The following article is part of our coverage of the Endocrine Society’s annual meeting (ENDO 2021) that is being held virtually from March 20-23, 2021. Endocrinology Advisor‘s staff will report on the top research in hormone science and clinical care. Check back for the latest news from ENDO 2021.
Dextroamphetamine may significantly reduce body mass index (BMI) and hyperphagia in children and adolescents with acquired hypothalamic obesity, according to study results presented at ENDO 2021, held virtually March 20-23.
A suprasellar tumor or its treatment can cause hypothalamic obesity in children; however, no effective drug treatments are currently available for this disease. Amphetamines commonly used to treat attention-deficit/hyperactivity disorder are known to inhibit appetite and increase resting energy expenditure (REE) and may benefit youth with hypothalamic obesity. The objective of this study was to observe the effects of dextroamphetamine in youth with genetic or acquired hypothalamic obesity.
In this study, researchers from the Netherlands evaluated 18 children with hypothalamic obesity treated with dextroamphetamine—13 of whom had acquired disease and 5 of whom had genetic disease. All participants received a 5 mg dose of dextroamphetamine once or twice a day, which was increased by 5 mg a day every week based on side effects and patient well-being. Outcome measures were anthropometrics, REE, changes in hyperphagic behavior, and side effects.
Results revealed that 10 children (55.6%) experienced clinically relevant weight loss. Of the patients with acquired hypothalamic obesity, 10 experienced weight loss (change in mean BMI standard deviation score [SDS] -1.09±1.00), 1 experienced BMI stabilization (change in BMI SDS +0.03), and 2 experienced an increase in BMI SDS (change in mean BMI SDS +0.32±0.05). Nine patients with acquired disease experienced a mean REE increase of +15.3%±10.5. Of the 5 patients with genetic disease, 3 experienced initial weight loss but gained their weight back to result in BMI stabilization (mean change in BMI SDS -0.08±0.19) at the end of follow-up. No difference in REE was observed before or during treatment in patients with genetic disease. Of all 18 patients in the study, 13 (72.2%) experienced improvements in hyperphagia, energy level, and/or behavior, and no serious side effects were reported.
Researchers concluded that dextroamphetamine may improve activity level and significantly reduce BMI and hyperphagia in youth with acquired hypothalamic obesity, but may not produce the same effects in youth with genetic hypothalamic obesity.
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van Schaik J, Welling MS, De Groot C, et al. Dextroamphetamine treatment for children with hypothalamic obesity. Presented at: ENDO 2021; March 20-23, 2021. Presentation OR02.