Wegovy boosts use of drugs for childhood obesity – 02/24/2024 – Equilíbrio

A small but growing number of U.S. teenagers began treatment with Novo Nordisk’s weight-loss drug Wegovy last year, according to data shared exclusively with Reuters.

In the first 10 months of 2023, 1,268 children ages 12 to 17 diagnosed with obesity began taking the drug, according to U.S. health insurance information compiled by health technology company Komodo Health.

In 2022, only 25 children were prescribed the drug which, until December of that year, was not approved for use in adolescents in the USA. A month later, the American Academy of Pediatrics recommended that weight-loss drugs be offered to obese children as young as 12 years old.

Data from Medicaid — a social health program — from five US states shows a similar increase in the use of Wegovy. The total numbers are still small, with at least 464 children in the regions receiving a prescription for the drug since January 2022.

This does not include prescriptions purchased without health insurance, or off-label use of two similar treatments for type 2 diabetes, Ozempic, also from Novo, and Mounjaro, from pharmaceutical company Eli Lilly.

Still, they make up a small portion, as nearly 20 percent of U.S. children, or about 14.7 million, have obesity, according to federal estimates.

But the data indicates growing interest among families in adopting Wegovy, the first proven effective treatment for obesity without the need for surgery. However, using the weekly injection can involve high costs, as well as limited information about long-term risks and benefits.

“I use these medications whenever I can. Unlike adults, where it’s like a rescue operation, we are much more likely to prevent illness in children and teens,” said Suzanne Cuda, medical director of Alamo City Healthy Kids and Families in San Antonio, Texas (USA). She was also an advisor to Novo Nordisk on pediatric obesity.

Obesity has been linked to many serious health conditions, including diabetes, heart disease and cancer.

In previous years, far fewer teenagers were prescribed Saxenda, also from Novo, which was approved for weight loss in adults in 2014, and for teenagers in 2020. The drug works in a similar way to Wegovy to reduce weight loss. appetite, but results in less weight loss. Both belong to a class of therapies known as GLP-1 agonists.

In the first 10 months of last year, 378 teenagers were prescribed Saxenda, according to data from Komodo. The number is lower than in 2022, when 567 patients started using the drug. From 2018 to 2021, 266 teens received new prescriptions for Saxenda.

FAMILY DECISION

Billy Small Jr. of Oakland, Calif., said he and his family were initially reluctant to use Wegovy on their 15-year-old son. They were concerned about side effects such as nausea, vomiting and other gastrointestinal problems, as well as possible unknown risks of long-term use. The clinical trial of Novo’s drug in adolescents lasted about 18 months.

Teenager Billy Small III is 5’9″ tall and weighed 176 pounds at the time. The pediatrician warned that he was at higher risk of developing type 2 diabetes and heart disease. He already had a diagnosis of asthma. “We asked him how he felt about it and he just wanted the weight to go away,” the father said.

Since he started using Wegovy in March 2023, Billy has lost about 40 pounds, or 23% of his total body weight. The medication was covered by the family’s state Medicaid plan.

Billy’s appetite decreased drastically and he had few side effects. He started going out with friends to watch movies and basketball games and started going to the gym with his father.

“The weight was affecting his confidence,” Billy Small Jr. said of his now 16-year-old son. “His quality of life is 100 times better than it was.”

Both Novo and Eli Lilly are testing their weight-loss medications in children as young as 6 years old. Lilly’s drug tirzepatide is only approved for adults in the US under the brand names Mounjaro, for type 2 diabetes, and Zepbound, for weight loss.

Lilly said it could not comment on “future plans for tirzepatide in children or adolescents as clinical trials are still ongoing.”

Novo said there are about 175 million children and teenagers with obesity worldwide, and for some, a low-calorie diet and increased exercise may not be enough.

GLOBAL EPIDEMIC

The USA is one of the countries that are testing new methods for weight loss in young people. Any new information could inform health authorities elsewhere. Novo said the drug received similar approvals for young people last year in Germany, the United Kingdom, Denmark and the United Arab Emirates.

Without health insurance coverage, Wegovy can cost up to US$1,300 per month in the USA. The data so far shows that most people who stop using it end up regaining some of the weight they lost. It is unclear whether there are ways to avoid the need for lifelong use.

Komodo reviewed health insurance data involving nearly 20 million children, or about 80% of the U.S. population ages 12 to 17. Among these patients, about 2.25 million had an obesity diagnosis listed on their insurance claims during the nearly six-year period. The analysis was with data up to October 2023.

Some medical experts urge caution due to a lack of evidence on how these medications may affect development.

The US Preventive Services Group recommends intensive counseling, including behavioral therapy and nutrition education, rather than medication, to help children who need to lose weight. “We really don’t know what these drugs do in the context of the growing child,” explained Dan Cooper, professor of pediatrics at the University of California.