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Methylphenidate in children with monogenic obesity due to LEPR or MC4R deficiency improves feeling of satiety and reduces BMI‐SDS—A case series
Author(s) -
Brandt Stephanie,
Schnurbein Julia,
Lennerz Belinda,
Kohlsdorf Katja,
Vollbach Heike,
Denzer Christian,
Bode Harald,
Hebebrand Johannes,
Wabitsch Martin
Publication year - 2020
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/ijpo.12577
Subject(s) - medicine , appetite , obesity , body mass index , melanocortin 4 receptor , leptin , methylphenidate , endocrinology , pediatrics , attention deficit hyperactivity disorder , psychiatry , melanocortin , receptor
Summary Background The clinical phenotype of patients with monogenic obesity due to mutations in the leptin receptor ( LEPR) or melanocortin 4 receptor ( MC4R ) gene is characterized by impaired satiety and hyperphagia, leading to extreme, sometimes life‐threatening weight gain. Subjects/methods In a case series, we analysed the effect of an off‐label methylphenidate (MPH) use for 1 year as an individual treatment approach on eating behaviour (Child Eating Behaviour Questionnaire [CEBQ]), appetite (visual analogue scales) and body mass index (BMI) trajectories in five patients with severe obesity due to mutations in the LEPR (n = 3) or MC4R (n = 2 ) gene. Results After 1 year use of MPH (20 mg/day divided in two to three doses), BMI (Δ BMI T0−T1x ¯ : −0.7 ± 0.9 kg/m 2 ), BMI standard deviation score (SDS) (Δ BMI‐SDS T0−T1x ¯ : −0.32 ± 0.20), and %BMIP95 (Δ %BMIP95 T0−T1x ¯ : −6.6 ± 7.8%) decreased. BMI‐SDS velocity decreased from +0.17 ± 0.22 to −0.30 ± 0.20. Appetite and CEBQ subscale scores for “food responsiveness” and “enjoyment of food” decreased. We observed adverse effects with increase in self‐reported frequency of disordered sleep, nervousness, hyperactivity, and tics. Conclusions The observed decrease in BMI trajectories with MPH use for one year is clinically meaningful in this group of patients, since the natural course would have been associated with a pronounced increase in BMI, leading to comorbidities and complications over time.