- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07590219
Use of Liraglutide in Children Aged 6 to 12 Years With Severe Obesity
Efficacy, Metabolic and Cardiovascular Effects of Liraglutide in Children Aged 6-12 Years With Severe Obesity: A Randomized Controlled Trial With Advanced Echocardiographic Assessment
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Childhood obesity is associated with early structural and functional cardiac alterations, including subclinical myocardial dysfunction. Conventional echocardiographic parameters may not detect early changes.
This is a prospective, randomized, controlled, open-label clinical trial including children aged 6-12 years with severe obesity (BMI Z-score ≥ +3). Participants are randomized to receive liraglutide plus lifestyle intervention or lifestyle intervention alone.
Participants are followed for 6 months with clinical, laboratory, imaging, and functional assessments.
In addition to the primary randomized comparison, a predefined longitudinal subgroup analysis is conducted in participants receiving liraglutide to assess cardiovascular effects using advanced echocardiographic techniques, including speckle-tracking analysis of left ventricular global longitudinal strain and left atrial reservoir strain.
This study was registered retrospectively because participant enrollment began prior to trial registration due to administrative reasons. The study protocol and outcomes were defined prior to participant inclusion.
Type d'étude
Inscription (Estimé)
Phase
- Phase 4
Contacts et emplacements
Lieux d'étude
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São Paulo
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São Paulo, São Paulo, Brésil, 05403-000
- Childrens Institute - University of Sao Paulo
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
Accepte les volontaires sains
La description
Inclusion Criteria:
- Children aged 6-12 years
- BMI Z-score ≥ +3
- Previous unsuccessful lifestyle intervention
Exclusion Criteria:
- Severe chronic diseases
- Cardiac disease
- Dermatological contraindication
- Use of interfering medications
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Liraglutide + Lifestyle Intervention
Participants receive liraglutide with dose escalation (0.6 mg to 3.0 mg daily) plus lifestyle intervention. Intervention: Drug: Liraglutide Behavioral: Lifestyle intervention |
Liraglutide administered as a once-daily subcutaneous injection, starting at 0.6 mg and titrated weekly up to 3.0 mg or maximum tolerated dose, for 6 months, combined with lifestyle intervention.
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Aucune intervention: Lifestyle Intervention Alone
Participants receive standard multidisciplinary lifestyle intervention without pharmacological treatment.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in Body Mass Index (BMI)
Délai: 6 months
|
Body mass index (BMI) will be calculated as body weight in kilograms divided by height in meters squared (kg/m²).
BMI will be assessed at baseline and after 6 months using standardized anthropometric measurements.
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6 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in left ventricular global longitudinal strain (LV-GLS) measured by two-dimensional speckle-tracking echocardiography
Délai: 6 months
|
LV-GLS will be obtained by transthoracic echocardiography using two-dimensional speckle-tracking analysis according to current American Society of Echocardiography recommendations.
Measurements will be expressed as percentage (%) and evaluated at baseline and after 6 months.
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6 months
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Change in left atrial reservoir strain (LASr) measured by two-dimensional speckle-tracking echocardiography
Délai: 6 months
|
LASr will be obtained from apical four-chamber views using two-dimensional speckle-tracking echocardiography and expressed as percentage (%).
Measurements will be performed at baseline and after 6 months according to current American Society of Echocardiography recommendations
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6 months
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Change in fasting plasma glucose
Délai: Baseline to 6 months
|
Fasting plasma glucose levels will be measured from venous blood samples and expressed in mg/dL.
Changes between baseline and 6 months will be evaluated.
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Baseline to 6 months
|
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Change in fasting insulin levels
Délai: 6 months
|
Fasting insulin levels will be measured from venous blood samples and expressed in µIU/mL.
Changes between baseline and 6 months will be evaluated
|
6 months
|
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Change in triglyceride levels
Délai: 6 months
|
Serum triglyceride levels will be measured from venous blood samples and expressed in mg/dL.
Changes between baseline and 6 months will be evaluated.
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6 months
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Change in total cholesterol levels
Délai: 6 months
|
Total cholesterol levels will be measured from venous blood samples and expressed in mg/dL.
Changes between baseline and 6 months will be evaluated.
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6 months
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Change in HDL cholesterol levels
Délai: 6 months
|
HDL cholesterol levels will be measured from venous blood samples and expressed in mg/dL.
Changes between baseline and 6 months will be evaluated.
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6 months
|
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Change in LDL cholesterol levels
Délai: 6 months
|
LDL cholesterol levels will be measured from venous blood samples and expressed in mg/dL.
Changes between baseline and 6 months will be evaluated.
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6 months
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Louise Cominato, PI, University of Sao Paulo
- Chaise d'étude: Natalia Bernardes, SI, University of Sao Paulo
Publications et liens utiles
Publications générales
- Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998 Jun 4;338(23):1650-6. doi: 10.1056/NEJM199806043382302.
- Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB; LEADER Steering Committee; LEADER Trial Investigators. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016 Jul 28;375(4):311-22. doi: 10.1056/NEJMoa1603827. Epub 2016 Jun 13.
- Kelly AS, Auerbach P, Barrientos-Perez M, Gies I, Hale PM, Marcus C, Mastrandrea LD, Prabhu N, Arslanian S; NN8022-4180 Trial Investigators. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. N Engl J Med. 2020 May 28;382(22):2117-2128. doi: 10.1056/NEJMoa1916038. Epub 2020 Mar 31.
- Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, Yanovski JA. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Mar 1;102(3):709-757. doi: 10.1210/jc.2016-2573.
- Weghuber D, Barrett T, Barrientos-Perez M, Gies I, Hesse D, Jeppesen OK, Kelly AS, Mastrandrea LD, Sorrig R, Arslanian S; STEP TEENS Investigators. Once-Weekly Semaglutide in Adolescents with Obesity. N Engl J Med. 2022 Dec 15;387(24):2245-2257. doi: 10.1056/NEJMoa2208601. Epub 2022 Nov 2.
- Harchali S, Zarrouki M, Elyadari M, Azenoud S, Elmerrouni S, Abdellah E, Berraho A. [Malignant conjunctival melanoma arising from conjunctival melanosis of Reese]. J Fr Ophtalmol. 2017 Nov;40(9):817-818. doi: 10.1016/j.jfo.2017.01.020. Epub 2017 Oct 19. No abstract available. French.
- Provenzano M, Andreucci M, Garofalo C, Faga T, Michael A, Ielapi N, Grande R, Sapienza P, Franciscis S, Mastroroberto P, Serra R. The Association of Matrix Metalloproteinases with Chronic Kidney Disease and Peripheral Vascular Disease: A Light at the End of the Tunnel? Biomolecules. 2020 Jan 17;10(1):154. doi: 10.3390/biom10010154.
- Erdivanli OC, Coskun ZO, Kazikdas KC, Demirci M. Prevalence of Otitis Media with Effusion among Primary School Children in Eastern Black Sea, in Turkey and the Effect of Smoking in the Development of Otitis Media with Effusion. Indian J Otolaryngol Head Neck Surg. 2012 Mar;64(1):17-21. doi: 10.1007/s12070-011-0131-z. Epub 2011 Feb 4.
- Wang HY, Sun LZ, Yue ZH, Yang J, Jiang XY, Mo Y. [Clinical and pathological features of Denys-Drash syndrome: report of 3 cases]. Zhonghua Er Ke Za Zhi. 2012 Nov;50(11):855-8. Chinese.
- Nauck MA, Vilsboll T, Gallwitz B, Garber A, Madsbad S. Incretin-based therapies: viewpoints on the way to consensus. Diabetes Care. 2009 Nov;32 Suppl 2(Suppl 2):S223-31. doi: 10.2337/dc09-S315. No abstract available.
- Caplan LS, Lane DS, Grimson R. The use of cohort vs repeated cross-sectional sample survey data in monitoring changing breast cancer screening practices. Prev Med. 1995 Nov;24(6):553-6. doi: 10.1006/pmed.1995.1088.
- Ferreira SRG, Macotela Y, Velloso LA, Mori MA. Determinants of obesity in Latin America. Nat Metab. 2024 Mar;6(3):409-432. doi: 10.1038/s42255-024-00977-1. Epub 2024 Mar 4.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Troubles nutritionnels
- Suralimentation
- Poids
- En surpoids
- Obésité
- Conditions pathologiques, signes et symptômes
- Maladies nutritionnelles et métaboliques
- Signes et symptômes
- Obésité pédiatrique
- Obésité morbide
- Hormones
- Hormones, substituts hormonaux et antagonistes hormonaux
- Hormones gastro-intestinales
- Peptides de type glucagon
- Progcagon
- Peptide de type glucagon 1
- Liraglutide
Autres numéros d'identification d'étude
- 74225723.4.0000.0068
Informations sur les médicaments et les dispositifs, documents d'étude
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