Octreotide Therapy of Pediatric Hypothalamic Obesity: A Double-Blind, Placebo-Controlled Trial
Hypothalamic obesity is a devastating complication in children surviving brain tumors and/or cranial irradiation. These subjects are thought to exhibit autonomic dysregulation of the β-cell, with insulin hypersecretion in response to oral glucose tolerance testing (OGTT). We report the results of a...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2003-06, Vol.88 (6), p.2586-2592 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Lustig, Robert H. Hinds, Pamela S. Ringwald-Smith, Karen Christensen, Robbin K. Kaste, Sue C. Schreiber, Randi E. Rai, Shesh N. Lensing, Shelly Y. Wu, Shengjie Xiong, Xiaoping |
| description | Hypothalamic obesity is a devastating complication in children surviving brain tumors and/or cranial irradiation. These subjects are thought to exhibit autonomic dysregulation of the β-cell, with insulin hypersecretion in response to oral glucose tolerance testing (OGTT). We report the results of a randomized, double-blind, placebo-controlled trial of octreotide therapy for pediatric hypothalamic obesity. Eighteen subjects [weight, 100.6 ± 5.6 kg; body mass index (BMI), 37.1 ± 1.3 kg/m2] received octreotide (5–15 μg/kg·d sc) or placebo for 6 months.
With octreotide, Δweight (mean ± sem) was +1.6 ± 0.6 vs. +9.1 ± 1.7 kg for placebo (P < 0.001). ΔBMI was −0.2 ± 0.2 vs. +2.2 ± 0.5 kg/m2, respectively (P < 0.001). OGTT documented Δinsulin response (peak − basal) of −417 ± 304 pm after octreotide vs. +216 ± 215 pm after placebo (P = 0.034). Improvement in physical activity by parent report was noted with octreotide, but not placebo (P = 0.03). For the octreotide group, changes in quality of life positively correlated with changes in insulin response (P = 0.041). Complications and adverse events were mild and self-limited.
These data demonstrate the beneficial effects of octreotide in pediatric hypothalamic obesity. Octreotide suppressed insulin, and stabilized weight and BMI. Improved quality of life correlated with the degree of insulin suppression. Octreotide was safe and well tolerated. |
| doi_str_mv | 10.1210/jc.2002-030003 |
| format | Article |
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With octreotide, Δweight (mean ± sem) was +1.6 ± 0.6 vs. +9.1 ± 1.7 kg for placebo (P < 0.001). ΔBMI was −0.2 ± 0.2 vs. +2.2 ± 0.5 kg/m2, respectively (P < 0.001). OGTT documented Δinsulin response (peak − basal) of −417 ± 304 pm after octreotide vs. +216 ± 215 pm after placebo (P = 0.034). Improvement in physical activity by parent report was noted with octreotide, but not placebo (P = 0.03). For the octreotide group, changes in quality of life positively correlated with changes in insulin response (P = 0.041). Complications and adverse events were mild and self-limited.
These data demonstrate the beneficial effects of octreotide in pediatric hypothalamic obesity. Octreotide suppressed insulin, and stabilized weight and BMI. Improved quality of life correlated with the degree of insulin suppression. Octreotide was safe and well tolerated.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2002-030003</identifier><identifier>PMID: 12788859</identifier><language>eng</language><publisher>United States: Endocrine Society</publisher><subject>Adolescent ; Blood Glucose - analysis ; Body Height - drug effects ; Body Mass Index ; Body Weight - drug effects ; Child ; Double-Blind Method ; Energy Intake - drug effects ; Female ; Hormones - adverse effects ; Hormones - therapeutic use ; Humans ; Hypothalamic Diseases - complications ; Insulin - blood ; Insulin-Like Growth Factor I - metabolism ; Leptin - blood ; Male ; Obesity - drug therapy ; Obesity - etiology ; Obesity - pathology ; Obesity - physiopathology ; Octreotide - adverse effects ; Octreotide - therapeutic use ; Placebos ; Quality of Life ; Safety</subject><ispartof>The journal of clinical endocrinology and metabolism, 2003-06, Vol.88 (6), p.2586-2592</ispartof><rights>Copyright © Oxford University Press 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4903-393a06e836413e51a3c484d60306f68eb1a74de0e3e874fbcf86516547ef73f43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12788859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lustig, Robert H.</creatorcontrib><creatorcontrib>Hinds, Pamela S.</creatorcontrib><creatorcontrib>Ringwald-Smith, Karen</creatorcontrib><creatorcontrib>Christensen, Robbin K.</creatorcontrib><creatorcontrib>Kaste, Sue C.</creatorcontrib><creatorcontrib>Schreiber, Randi E.</creatorcontrib><creatorcontrib>Rai, Shesh N.</creatorcontrib><creatorcontrib>Lensing, Shelly Y.</creatorcontrib><creatorcontrib>Wu, Shengjie</creatorcontrib><creatorcontrib>Xiong, Xiaoping</creatorcontrib><title>Octreotide Therapy of Pediatric Hypothalamic Obesity: A Double-Blind, Placebo-Controlled Trial</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Hypothalamic obesity is a devastating complication in children surviving brain tumors and/or cranial irradiation. These subjects are thought to exhibit autonomic dysregulation of the β-cell, with insulin hypersecretion in response to oral glucose tolerance testing (OGTT). We report the results of a randomized, double-blind, placebo-controlled trial of octreotide therapy for pediatric hypothalamic obesity. Eighteen subjects [weight, 100.6 ± 5.6 kg; body mass index (BMI), 37.1 ± 1.3 kg/m2] received octreotide (5–15 μg/kg·d sc) or placebo for 6 months.
With octreotide, Δweight (mean ± sem) was +1.6 ± 0.6 vs. +9.1 ± 1.7 kg for placebo (P < 0.001). ΔBMI was −0.2 ± 0.2 vs. +2.2 ± 0.5 kg/m2, respectively (P < 0.001). OGTT documented Δinsulin response (peak − basal) of −417 ± 304 pm after octreotide vs. +216 ± 215 pm after placebo (P = 0.034). Improvement in physical activity by parent report was noted with octreotide, but not placebo (P = 0.03). For the octreotide group, changes in quality of life positively correlated with changes in insulin response (P = 0.041). Complications and adverse events were mild and self-limited.
These data demonstrate the beneficial effects of octreotide in pediatric hypothalamic obesity. Octreotide suppressed insulin, and stabilized weight and BMI. Improved quality of life correlated with the degree of insulin suppression. Octreotide was safe and well tolerated.</description><subject>Adolescent</subject><subject>Blood Glucose - analysis</subject><subject>Body Height - drug effects</subject><subject>Body Mass Index</subject><subject>Body Weight - drug effects</subject><subject>Child</subject><subject>Double-Blind Method</subject><subject>Energy Intake - drug effects</subject><subject>Female</subject><subject>Hormones - adverse effects</subject><subject>Hormones - therapeutic use</subject><subject>Humans</subject><subject>Hypothalamic Diseases - complications</subject><subject>Insulin - blood</subject><subject>Insulin-Like Growth Factor I - metabolism</subject><subject>Leptin - blood</subject><subject>Male</subject><subject>Obesity - drug therapy</subject><subject>Obesity - etiology</subject><subject>Obesity - pathology</subject><subject>Obesity - physiopathology</subject><subject>Octreotide - adverse effects</subject><subject>Octreotide - therapeutic use</subject><subject>Placebos</subject><subject>Quality of Life</subject><subject>Safety</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1OwzAQhC0EglK4ckR5AFzs2IkdbqX8FKlSORSJE5bjbNQUN47sVFXfHkOQOHFajXZmtPshdEXJhKaU3G7MJCUkxYQRQtgRGtGCZ1jQQhyjUVxQXIj0_Qydh7AhhHKesVN0RlMhpcyKEfpYmt6D65sKktUavO4OiauTV6ga3fvGJPND5_q1tnobxbKE0PSHu2SaPLhdaQHf26atbpJXqw2UDs9c23tnLVTJyjfaXqCTWtsAl79zjN6eHlezOV4sn19m0wU2vCAMs4JpkoNkOacMMqqZ4ZJXefwqr3MJJdWCV0CAgRS8Lk0t84zmGRdQC1ZzNkaTodd4F4KHWnW-2Wp_UJSob1BqY9Q3KDWAioHrIdDtyi1Uf_ZfMtHAB8Pe2R58-LS7PXi1Bm37tYodhOdC4tgZb4wK_9TGWDbEoK2c8U0LnYcQ1MbtfBsJ_HfPF0X_hAg</recordid><startdate>200306</startdate><enddate>200306</enddate><creator>Lustig, Robert H.</creator><creator>Hinds, Pamela S.</creator><creator>Ringwald-Smith, Karen</creator><creator>Christensen, Robbin K.</creator><creator>Kaste, Sue C.</creator><creator>Schreiber, Randi E.</creator><creator>Rai, Shesh N.</creator><creator>Lensing, Shelly Y.</creator><creator>Wu, Shengjie</creator><creator>Xiong, Xiaoping</creator><general>Endocrine Society</general><general>Copyright Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>200306</creationdate><title>Octreotide Therapy of Pediatric Hypothalamic Obesity: A Double-Blind, Placebo-Controlled Trial</title><author>Lustig, Robert H. ; Hinds, Pamela S. ; Ringwald-Smith, Karen ; Christensen, Robbin K. ; Kaste, Sue C. ; Schreiber, Randi E. ; Rai, Shesh N. ; Lensing, Shelly Y. ; Wu, Shengjie ; Xiong, Xiaoping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4903-393a06e836413e51a3c484d60306f68eb1a74de0e3e874fbcf86516547ef73f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adolescent</topic><topic>Blood Glucose - analysis</topic><topic>Body Height - drug effects</topic><topic>Body Mass Index</topic><topic>Body Weight - drug effects</topic><topic>Child</topic><topic>Double-Blind Method</topic><topic>Energy Intake - drug effects</topic><topic>Female</topic><topic>Hormones - adverse effects</topic><topic>Hormones - therapeutic use</topic><topic>Humans</topic><topic>Hypothalamic Diseases - complications</topic><topic>Insulin - blood</topic><topic>Insulin-Like Growth Factor I - metabolism</topic><topic>Leptin - blood</topic><topic>Male</topic><topic>Obesity - drug therapy</topic><topic>Obesity - etiology</topic><topic>Obesity - pathology</topic><topic>Obesity - physiopathology</topic><topic>Octreotide - adverse effects</topic><topic>Octreotide - therapeutic use</topic><topic>Placebos</topic><topic>Quality of Life</topic><topic>Safety</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lustig, Robert H.</creatorcontrib><creatorcontrib>Hinds, Pamela S.</creatorcontrib><creatorcontrib>Ringwald-Smith, Karen</creatorcontrib><creatorcontrib>Christensen, Robbin K.</creatorcontrib><creatorcontrib>Kaste, Sue C.</creatorcontrib><creatorcontrib>Schreiber, Randi E.</creatorcontrib><creatorcontrib>Rai, Shesh N.</creatorcontrib><creatorcontrib>Lensing, Shelly Y.</creatorcontrib><creatorcontrib>Wu, Shengjie</creatorcontrib><creatorcontrib>Xiong, Xiaoping</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lustig, Robert H.</au><au>Hinds, Pamela S.</au><au>Ringwald-Smith, Karen</au><au>Christensen, Robbin K.</au><au>Kaste, Sue C.</au><au>Schreiber, Randi E.</au><au>Rai, Shesh N.</au><au>Lensing, Shelly Y.</au><au>Wu, Shengjie</au><au>Xiong, Xiaoping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Octreotide Therapy of Pediatric Hypothalamic Obesity: A Double-Blind, Placebo-Controlled Trial</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2003-06</date><risdate>2003</risdate><volume>88</volume><issue>6</issue><spage>2586</spage><epage>2592</epage><pages>2586-2592</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><abstract>Hypothalamic obesity is a devastating complication in children surviving brain tumors and/or cranial irradiation. These subjects are thought to exhibit autonomic dysregulation of the β-cell, with insulin hypersecretion in response to oral glucose tolerance testing (OGTT). We report the results of a randomized, double-blind, placebo-controlled trial of octreotide therapy for pediatric hypothalamic obesity. Eighteen subjects [weight, 100.6 ± 5.6 kg; body mass index (BMI), 37.1 ± 1.3 kg/m2] received octreotide (5–15 μg/kg·d sc) or placebo for 6 months.
With octreotide, Δweight (mean ± sem) was +1.6 ± 0.6 vs. +9.1 ± 1.7 kg for placebo (P < 0.001). ΔBMI was −0.2 ± 0.2 vs. +2.2 ± 0.5 kg/m2, respectively (P < 0.001). OGTT documented Δinsulin response (peak − basal) of −417 ± 304 pm after octreotide vs. +216 ± 215 pm after placebo (P = 0.034). Improvement in physical activity by parent report was noted with octreotide, but not placebo (P = 0.03). For the octreotide group, changes in quality of life positively correlated with changes in insulin response (P = 0.041). Complications and adverse events were mild and self-limited.
These data demonstrate the beneficial effects of octreotide in pediatric hypothalamic obesity. Octreotide suppressed insulin, and stabilized weight and BMI. Improved quality of life correlated with the degree of insulin suppression. Octreotide was safe and well tolerated.</abstract><cop>United States</cop><pub>Endocrine Society</pub><pmid>12788859</pmid><doi>10.1210/jc.2002-030003</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The journal of clinical endocrinology and metabolism, 2003-06, Vol.88 (6), p.2586-2592 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adolescent Blood Glucose - analysis Body Height - drug effects Body Mass Index Body Weight - drug effects Child Double-Blind Method Energy Intake - drug effects Female Hormones - adverse effects Hormones - therapeutic use Humans Hypothalamic Diseases - complications Insulin - blood Insulin-Like Growth Factor I - metabolism Leptin - blood Male Obesity - drug therapy Obesity - etiology Obesity - pathology Obesity - physiopathology Octreotide - adverse effects Octreotide - therapeutic use Placebos Quality of Life Safety |
| title | Octreotide Therapy of Pediatric Hypothalamic Obesity: A Double-Blind, Placebo-Controlled Trial |
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