Brain Activation and Satiety in Children 2 (BASIC2)
Brain Systems and Behaviors Underlying Response to Obesity Treatment in Children
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Using functional and structural magnetic resonance neuroimaging, this study will evaluate brain factors which could undermine treatment responses and long-term obesity intervention outcomes. Specific Aim 1 will test the effect of adding ExQW to FBT on change in BMI z-score over a total GLP-1RA treatment duration of 24 weeks and a subsequent 1-year observational follow-up period after treatment cessation. To provide mechanistic insight, Specific Aim 2 will test whether adding GLP-1RA intervention to FBT impacts neural activation by food cues. Finally, the proposed research will investigate the role of a cellular inflammatory process in the mediobasal hypothalamus-called gliosis-which might contribute to impaired hypothalamic function, attenuated satiety responsiveness, and potentially to worse weight management outcomes. Specific Aim 3 will test if hypothalamic gliosis is modified by FBT and/or FBT plus GLP-1RA in children and if its extent is related to immediate and/or long-term intervention outcomes.
Study Design: This double-blinded, randomized, placebo-controlled research study uses fMRI to characterize neural responses to a test meal before and at the end of FBT intervention, with vs. without additional GLP-1RA intervention. In addition, it uses structural MRI (sMRI) to test if MBH gliosis is reversible and/or associated with intervention outcomes.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Christian L Roth, MD
- Phone Number: 206-987-5428
- Email: christian.roth@seattlechildrens.org
Study Contact Backup
- Name: Clinton T Elfers
- Phone Number: 206-884-1256
- Email: clinton.elfers@seattlechildrens.org
Study Locations
-
-
Washington
-
Seattle, Washington, United States, 98105
- Seattle Children's Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 10-12 years of age
- Male or female
- Ability and willingness to participate in study visits including fMRI scans, blood draws, and weekly injections;
- Parent willing to provide informed written consent and child willing to provide written assent;
- Child has BMI z-score >95th percentile. for age and sex;
- One parent that is obese or overweight (BMI >27 kg/m2); willingness of 1 parent (does not have to be the parent with obesity) to engage in weekly family-based weight control treatment delivered in English.
Exclusion Criteria:
- History of acute or chronic serious medical conditions;
- known diabetes mellitus or recent (6 mo.) history of anemia;
- Presence of any implanted metal or metal devices, including ferro-metallic surgical clips or orthodontic braces;
- Claustrophobia;
- Documented cognitive disorder, disruptive behavior, inability to participate in group sessions;
- Current use of medications known to alter appetite, body weight, or brain response
- Food intolerance to test meal (macaroni and cheese) or vegetarianism/veganism or severe food allergies.
- Known renal impairment (GFR<60 ml/min/1.73m2)
- History of gastroparesis, pancreatitis or gallstones (unless status post cholecystectomy);
- Family history of multiple endocrine neoplasia type 2 or familial medullary thyroid carcinoma;
- Known elevated calcitonin level at phone screening or increased measured calcitonin level at study visits;
- Untreated thyroid disorder or adrenal insufficiency;
- Use of weight loss medications (child participant) within 3 months of screening visit.
- Participating parent is pregnant
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Exenatide once weekly extended-release
Weekly subcutaneous injections of glucagon-like peptide (GLP)-1 agonist exenatide once weekly extended-release (2mg) for 24 weeks in randomized intervention.
|
Children with obesity accompanied by at least one parent or caregiver will attend 24 weekly sessions.
Most sessions will be held via video-conference and include 25-30 min.
meetings between an interventionist and each child/parent pair to individualize treatment, followed by separate child and parent group meetings lasting 40 - 45 min.
A select few sessions will be held in-person between an interventionist and each child/parent pair with no group session.
Parents will serve as primary agents of change for their child and for themselves.
Training will focus on food and physical activity education, parenting around food and physical activity, and use of behavioral skills (e.g., self-monitoring, environmental control, contingency management).
Intervention groups of 8-12 children/families will be initiated every 3-6 mos. in study yrs.
2-3.
Weekly injections of active drug.
Other Names:
|
|
Placebo Comparator: Matching placebo
Weekly subcutaneous injections of placebo for 24 weeks.
|
Children with obesity accompanied by at least one parent or caregiver will attend 24 weekly sessions.
Most sessions will be held via video-conference and include 25-30 min.
meetings between an interventionist and each child/parent pair to individualize treatment, followed by separate child and parent group meetings lasting 40 - 45 min.
A select few sessions will be held in-person between an interventionist and each child/parent pair with no group session.
Parents will serve as primary agents of change for their child and for themselves.
Training will focus on food and physical activity education, parenting around food and physical activity, and use of behavioral skills (e.g., self-monitoring, environmental control, contingency management).
Intervention groups of 8-12 children/families will be initiated every 3-6 mos. in study yrs.
2-3.
Weekly placebo injections
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change of BMI z-score
Time Frame: Change from drug treatment randomization at week 8 of family-based behavioral treatment (FBT) to end of combined intervention (FBT + drug) at week 24 of FBT
|
Body mass index (BMI) z-scores will be derived using CDC growth charts, using the LMS method, to allow for comparison of adiposity over time and across children who differ in age and sex.
|
Change from drug treatment randomization at week 8 of family-based behavioral treatment (FBT) to end of combined intervention (FBT + drug) at week 24 of FBT
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
BMI z-score
Time Frame: Up to 12-months after ending treatment
|
Change of body mass index (BMI) z-scores derived using CDC growth charts, using the LMS method, to allow for comparison of adiposity over time and across children who differ in age and sex.
|
Up to 12-months after ending treatment
|
|
Body composition
Time Frame: Change from Baseline to post-Family Based Behavioral Treatment at week 24 and post drug-treatment at week 32
|
Changes in body composition as assessed using a bioelectrical impedance (BIA)
|
Change from Baseline to post-Family Based Behavioral Treatment at week 24 and post drug-treatment at week 32
|
|
Indices of metabolic syndrome
Time Frame: Change from Baseline to post-Family Based Behavioral Treatment at week 24
|
Changes of insulin resistance assessed by fasting insulin used for homeostasis model assessment of insulin resistance (HOMA-IR) using the formula insulin [mU/l] x glucose [mmol/l]) / 22.5
|
Change from Baseline to post-Family Based Behavioral Treatment at week 24
|
|
Meal induced chances in brain activation to visual food cues
Time Frame: Change from Baseline to post-Family Based Behavioral Treatment at week 24
|
Change of brain response to visual food cues measured by functional magnetic resonance imaging in a priori regions of interest
|
Change from Baseline to post-Family Based Behavioral Treatment at week 24
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- STUDY00001984
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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