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Dextroamphetamine Treatment in Children With Hypothalamic Obesity
Jiska van Schaik1,2, Mila S Welling3,4, Corjan J de Groot3,4
1Division of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
Frontiers in Endocrinology
|March 31, 2022
Summary
Dextroamphetamine treatment shows promise for improving body mass index (BMI) and reducing hyperphagia in children with hypothalamic obesity (HO). This study suggests potential benefits for resting energy expenditure and behavior, particularly in acquired HO cases.
Area of Science:
- Pediatric Endocrinology
- Metabolic Disorders
- Pharmacology
Background:
- Hypothalamic obesity (HO) in children presents significant health challenges with limited treatment options.
- Current lifestyle interventions are often insufficient, and no approved drug therapies exist for pediatric HO.
- Amphetamines, known for increasing resting energy expenditure (REE) and suppressing appetite, have shown potential in prior case studies.
Purpose of the Study:
- To evaluate the efficacy and safety of off-label dextroamphetamine treatment in a cohort of children with hypothalamic obesity.
- To assess the impact of dextroamphetamine on anthropometrics, resting energy expenditure, hyperphagic behavior, and energy levels.
Main Methods:
- A retrospective cohort study of 19 children with acquired or congenital HO treated with dextroamphetamine.
- Assessment of anthropometrics (BMI SDS), REE, hyperphagia, energy levels, and side effects before and during treatment.
- Data collected from two academic pediatric endocrine clinics.
Main Results:
- Fourteen of 17 evaluated patients (82%) showed BMI decline or stabilization (mean ΔBMI SDS of -0.6 ± 0.8).
- Responders experienced an 8.9% increase in measured REE (REE/predicted REE).
- Thirteen patients (68.4%) reported decreased hyperphagia and improved energy/behavior; two developed hypertension.
Conclusions:
- Dextroamphetamine may improve BMI, decrease hyperphagia, and enhance REE, behavior, and energy levels in children with HO.
- Effects appear more pronounced in acquired HO compared to congenital HO.
- Further research is necessary to validate these findings and establish treatment guidelines.
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