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Mobility for All?

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Metformin effectively manages weight gain in children and adolescents with autism spectrum disorder using second-generation antipsychotics (SGAs). This study shows metformin is well-tolerated and improves body mass index z-scores in this vulnerable population.

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Area of Science:

  • Pediatric Pharmacology
  • Neurodevelopmental Disorders
  • Metabolic Health

Background:

  • Second-generation antipsychotics (SGAs) are frequently prescribed for children and adolescents, but their use is associated with significant cardiometabolic risks.
  • Autism spectrum disorder (ASD) is a common neurodevelopmental condition often treated with SGAs, exacerbating concerns about metabolic side effects.
  • A prior study established the efficacy of liquid metformin in mitigating SGA-induced weight gain in youth with ASD.

Discussion:

  • This open-label extension study evaluated the tolerability and efficacy of liquid metformin in youth (6-17 years) with ASD previously treated with SGAs.
  • Metformin was well-tolerated across both the acute-phase and open-label extension periods.
  • Significant improvements in body mass index (BMI) z-scores were observed in participants receiving metformin, regardless of prior treatment group.

Key Insights:

  • Liquid metformin is a safe and effective intervention for managing weight gain and improving BMI z-scores in pediatric patients with ASD on SGAs.
  • Metformin demonstrated sustained benefits in weight management, supporting its role in mitigating cardiometabolic adverse effects of SGAs.
  • The findings reinforce the potential of metformin as an adjunctive therapy to improve metabolic health in youth with ASD treated with antipsychotics.

Outlook:

  • Further research could explore long-term cardiometabolic outcomes and optimal dosing strategies for metformin in this population.
  • Investigating the impact of metformin on other metabolic parameters beyond BMI is warranted.
  • These findings support the integration of metformin into clinical practice guidelines for managing SGA-associated metabolic disturbances in pediatric ASD.