Another tool for adolescent obesity — this is a study geared towards 13-18 year olds who were in the 95th percentile for their BMI.

From Medscape:

Metformin Extended Release May Be Helpful for Adolescent Obesity

Laurie Barclay, MD

February 2, 2010 — Metformin hydrochloride extended release (XR) with lifestyle intervention may be helpful for the treatment of adolescent obesity, according to the results of a multicenter, randomized controlled trial reported in the February issue of the Archives of Pediatrics & Adolescent Medicine.

“Metformin has been proffered as a therapy for adolescent obesity, although long-term controlled studies have not been reported,” write Darrell M. Wilson, MD, from Lucile Salter Packard Children’s Hospital, Stanford University School of Medicine in Stanford, California, and colleagues from the Glaser Pediatric Research Network Obesity Study Group. “Therefore, we conducted a 48-week randomized, double-blind, placebo-controlled trial of…XR metformin therapy in nondiabetic obese adolescents, followed by a 48-week monitoring period after completion of treatment.”

The goal of the study was to test the hypothesis that 48 weeks of daily metformin XR treatment would reduce body mass index (BMI) in obese adolescents vs placebo.

From October 2003 to August 2007 at the 6 centers of the Glaser Pediatric Research Network, 78 obese adolescents following a lifestyle intervention program underwent a 1-month run-in period and were then randomly assigned 1:1 to receive 48 weeks of treatment with metformin hydrochloride XR, 2000 mg once daily or an identical placebo. At baseline, BMI was at least in the 95th percentile, and age range was 13 to 18 years. The main study endpoint was change in BMI, after adjustment for site, sex, race, ethnicity, and age, and group assignment.

Mean adjusted BMI increased by 0.2 ± 0.5 in the placebo group and decreased by 0.9 ± 0.5 in the metformin XR group (P = .03) after 48 weeks of treatment, and this difference persisted for 12 to 24 weeks after cessation of treatment. There were no significant effects of metformin on body composition, abdominal fat, or insulin indices.

“Metformin XR caused a small but statistically significant decrease in BMI when added to a lifestyle intervention program,” the study authors write.

Limitations of this study include study not specifically powered to evaluate the effect of metformin on insulin and lipid indices.

“Metformin was safe and tolerated in this population,” the study authors conclude. “These results indicate that metformin may have an important role in the treatment of adolescent obesity. Longer-term studies will be needed to define the effects of metformin treatment on obesity-related disease risk in this population.”

Bristol-Myers Squibb provided active drug (GlucophageXR) and placebos. The Glaser Pediatric Research Network is funded by the Elizabeth Glaser Pediatric Research Foundation, a program of the Elizabeth Glaser Pediatric AIDS Foundation. The study was supported by the Elizabeth Glaser Pediatric Research Foundation and the National Institutes of Health–supported Clinical Research Centers.

Arch Pediatr Adolesc Med. 2010;164:116-123.

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