Liraglutide 3 mg as a weight-loss strategy after failed bariatric surgery in a patient with hypothalamic obesity following craniopharyngioma

Bretault, Marion; Carette, Claire; Zaharia, Ramona; Vychnevskaia, Karina; Bouillot, Jean‐Luc; Czernichow, Sébastien; Raffin-Sanson, Marie-Laure

doi:10.1016/j.diabet.2019.07.004

Cited by 15 publications

(7 citation statements)

References 7 publications

(8 reference statements)

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“…This suggests a potential mechanism for GLP-1RA beyond delaying gastric emptying. 25 Indeed, a study found that patients with craniopharyngioma had a loss of post-prandial GLP-1 secretion which was restored after gastric-bypass surgery, where restoration of GLP-1 secretion correlated with weight loss and reduced appetite. 38 These observations suggest that the central effects of GLP-1 are not lost in HO, despite the expected disruptions to the satiety centre.…”

Section: Discussionmentioning

confidence: 99%

“…One of the patients in this review had a remarkable response to liraglutide with 16% (29 kg) of weight reduction, even after an ineffective gastric bypass surgery. This suggests a potential mechanism for GLP‐1RA beyond delaying gastric emptying 25 . Indeed, a study found that patients with craniopharyngioma had a loss of post‐prandial GLP‐1 secretion which was restored after gastric‐bypass surgery, where restoration of GLP‐1 secretion correlated with weight loss and reduced appetite 38 .…”

Section: Discussionmentioning

confidence: 99%

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The role of glucagon‐like peptide 1 receptor agonists for weight control in individuals with acquired hypothalamic obesity—A systematic review

Ng,

Gerard,

Koh

et al. 2024

Clinical Obesity

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SummaryHypothalamic obesity does not respond well to conventional interventions for obesity. GLP‐1 receptor agonists have mechanisms independent of the hypothalamus which may be potentially beneficial for managing hypothalamic obesity. This systematic review summarizes the efficacy and safety of GLP‐1 receptor agonists use in hypothalamic obesity. A PRISMA‐compliant systematic review was performed. Data was extracted from included studies and analysed based on change in weight, body mass index, glycaemic control, satiety, and safety profile with GLP‐1 receptor agonist use. Ten studies comprising 5 case reports, 4 case series and 1 randomized‐controlled trial included 54 patients (24 males, 30 females) with mean age of 25.2 (range 13–71) years with hypothalamic obesity who had received GLP‐1 receptor agonists (exenatide = 48, liraglutide = 5 and dulaglutide = 1) over a mean duration of treatment of 12 (range 3–51) months. Mean weight reduction of 7.4 (SD 7.92) kg was observed in patients in whom weight was reported, with 85.7% of patients experiencing weight loss. All patients on liraglutide had weight reduction post‐therapy. The sole trial had reported a non‐significant reduction in BMI post‐exenatide. Glycaemic control had either improved/maintained in all patients in whom this was measured. The main side effects of GLP‐1 receptor agonist in individuals with hypothalamic obesity were nausea and vomiting; there were no major safety concerns. Based on limited published experience, GLP‐1RA may be effective and safe for weight control in hypothalamic obesity, with the added benefit of improved glycaemic control in those with concurrent diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of glucagon‐like peptide 1 receptor agonists for weight control in individuals with acquired hypothalamic obesity—A systematic review

Ng,

Gerard,

Koh

et al. 2024

Clinical Obesity

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“…Five case reports focusing on either a single individual or very few individuals with HO found results similar to our study with substantial weight reduction accompanying treatment with GLP-1 analogues. Most of these studies used liraglutide, but also Exendin-4, Dulaglutide and Exenatide were used [13][14][15][16][17]. Pharmacological treatments for acquired HO, besides GLP-1 receptor agonists, have previously been investigated, of which the most promising include treatment with methionine aminopeptidase inhibitors [25], dextroamphetamine [26,27] and Tesomet (tesofensine combined with metoprolol) [28].…”

Section: Discussionmentioning

confidence: 99%

“…Successful treatment of HO using GLP-1 analogues has been suggested in case reports and in a few intervention studies employing different type and dosages of GLP-1 analogues. Most studies used daily injection with liraglutide or exendin-4 [13][14][15][16]. Two other studies -a case report and one randomized-controlled trial (RCT) -has investigated the effect of weekly injection with longacting exenatide or dulaglutide [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Semaglutide treatment of hypothalamic obesity – a real-life data study

Svendstrup,

Rasmussen,

Kistorp

et al. 2024

Preprint

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Purpose Patients with tumors involving the hypothalamic region are at high risk of developing morbid obesity due to disturbances in the appetite regulative nuclei in hypothalamus. We evaluated the effect of Glucagon-like peptide 1 (GLP-1) analogue treatment in patients with hypothalamic obesity.Methods We recorded weight changes from real-time data before and after treatment with the GLP-1 analogue semaglutide in patients hypothalamic obesity from our outpatient clinic at the Department of Endocrinology at Rigshospitalet, from September 2020 to November 2023.Results A total of 26 patients were included in this study (15 females, median age at initiation of semaglutide was 52 (18–65) years). Body weight at initial diagnosis was median 80 kg (range 50–140) while body weight at initiation of semaglutide was median 116 kg (range 76–175). All but one patient lost weight during semaglutide treatment with a mean weight loss of 12.5 kg (95% CI 8.4–16.5 kg, p = < 0.001) after one year (median 11.4 months) with an average dosage of semaglutide of 1.6 mg (range 0.5–2.5). There was no significant difference in weight loss between patients previously treated with liraglutide and patients naïve to GLP-1 analogues (p = 0.35). Fifteen patients (58%) lost more than 10% and 2 patients (8%) lost more than 20% of initial body weight, respectively.Conclusion Treatment with semaglutide shows promising results in reducing body weight in patients with acquired hypothalamic obesity. Whether the weight reduction remains stable after long time follow-up needs further investigation.

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“…In a small study of 10 patients with different causes of hypothalamic obesity, treatment with the GLP-1 analogue exenatide resulted in weight stabilization or decrease ( 31 ). It might also contribute to strategies to maintain weight loss after bariatric surgery: For example, the GLP-1 analogue liraglutide provided weight loss in a patient with craniopharyngioma whose bariatric surgery failed to be effective long term ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery for Hypothalamic Obesity in Craniopharyngioma Patients: A Retrospective, Matched Case-Control Study

Santen

Wolf

Kremenevski

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Craniopharyngioma is a sellar tumor associated with high rates of pituitary deficiencies (~98%) and hypothalamic obesity (~50%). Objective To determine the efficacy regarding long-term weight loss after bariatric surgery in obese craniopharyngioma patients with hypothalamic dysfunction. Design Retrospective case control study. Setting Multicenter international study. Patients and participants Obese craniopharyngioma patients (N = 16; of which 12 women) with a history of bariatric surgery [12 Roux-en-Y gastric bypass, 4 sleeve gastrectomy; median age of 21 years (range 15-52), median follow-up 5.2 years (range 2.0-11.3)] and age/sex/surgery/BMI-matched obese controls (N = 155). Main outcome measures Weight loss and obesity-related comorbidities up to 5 years after bariatric surgery were compared and changes in hormonal replacement therapy evaluated. Results Mean weight loss at 5-year follow-up was 22.0% (95% CI 16.1, 27.8) in patients versus 29.5% (28.0, 30.9) in controls (P = 0.02), which was less after Roux-en-Y gastric bypass (22.7% [16.9, 28.5] vs. 32.0% [30.4, 33.6]; P = 0.003) but at a similar level after sleeve gastrectomy (21.7% [–1.8, 45.2] vs. 21.8% [18.2, 25.5]; P = 0.96). No major changes in endocrine replacement therapy were observed after surgery. One patient died (unknown cause). One patient had long-term absorptive problems. Conclusions Obese patients with craniopharyngioma had a substantial mean weight loss of 22% at 5-year follow-up after bariatric surgery, independent of type of bariatric surgery procedure. Weight loss was lower than in obese controls after Roux-en-Y gastric bypass. Bariatric surgery appears effective and relatively safe in the treatment of obese craniopharyngioma patients.

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Liraglutide 3 mg as a weight-loss strategy after failed bariatric surgery in a patient with hypothalamic obesity following craniopharyngioma

Cited by 15 publications

References 7 publications

The role of glucagon‐like peptide 1 receptor agonists for weight control in individuals with acquired hypothalamic obesity—A systematic review

The role of glucagon‐like peptide 1 receptor agonists for weight control in individuals with acquired hypothalamic obesity—A systematic review

Semaglutide treatment of hypothalamic obesity – a real-life data study

Bariatric Surgery for Hypothalamic Obesity in Craniopharyngioma Patients: A Retrospective, Matched Case-Control Study

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