Nevertheless,
Despite new drugs, global management new: This article explores the topic in depth.
Furthermore,
Despite new drugs. However. In addition, global management new: For example,
Despite new drugs, global management:
Lyon-Where are we the courses of the child with obesity in France? Similarly. Similarly. Moreover, This was the theme of the intervention of Pre Rachel Reynaud et Béatrice Dubernboth coordinators of centers specializing in the management of obesity. However, during the congress of the French Pediatric Society (SFP). In addition, The opportunity to present the new treatments, which significantly modify the management.
Prevention. Consequently. Moreover. Similarly, support networks in support
“Taking charge of a person in obesity is not just about prescribing drugs,” recalls the pre Rachel Reynaud, a pediatric endocrinologist at the Timone in Marseille (APHM). Nevertheless, “It is a disorder in the energy balance. Furthermore. Nevertheless. Therefore, modulated by food and physical activity, despite new drugs, global management new but it is not in behavioral disorders and is not necessarily the patient’s fault,” she insists.
For this specialist, despite new drugs, global management new “the individual situation must be included in a global environmental context. Similarly, despite new drugs, global management Moreover, From 2016. In addition. For example. Moreover, theWorld Health Organization (WHO) has defined the objective of putting an end to the obesity of the child, through individual elements, but also with a role of care in society ”. Nevertheless. Consequently. Meanwhile, As such, it considers it important that public health actions are implemented: prevention, health education and environmental policy in particular.
“The recommendations of the High Authority for Health (HAS) on the child’s journey advocate obesity screening. Nevertheless. However. Similarly, which can be carried out by maternal and child protection (PMI), school medicine, but also by all doctors who take care of children,” she said. In addition, despite new drugs, global management new Prevention and management networks of pediatric obesity (reppop) can support.
“If obesity is complex, children must be oriented towards a center specializing in the management of obesity (CSO). despite new drugs, global management new However, There are now 37 in France, ”she says. Therefore. The center must then be interested in pathophysiology. determine the despite new drugs, global management mechanisms that alter energy balance.
Restore the satiety signal
The pre Béatrice Dubern. Meanwhile. specialist in pediatric nutrition in the specialized center of Île-de-France-Est (APHP) obesity. detailed the contribution of the setmélantide in the management. Furthermore, “This medication is intended for complex, very severe situations, with a hypothalamic dysfunction of appetite control,” she explains.
The setmélastide being an MC4R agonist, he will return the satiety signal. “It works very well. The first patients treated 10 years ago experienced rapid weight loss. which is maintained, with an eating behavior which despite new drugs, global management new has almost normalized and an improvement in quality of life, “she says.
“This molecule represents an extraordinary hope among pediatricians. because for the first time. it is possible to propose treatment allowing an despite new drugs. global management new improvement in corpulence in these rare but early forms of obesity”. She takes the example of a 5 -year -old child with extremely severe obesity. treated despite new drugs, global management at Trousseau hospital. “Thanks to the treatment, we have observed an improvement in its obesity and hyperphagia. It improved not only his quality of life, but also that of his parents! ».
In Bardet-BiDL syndrome. which is also explained by a dysfunction of the MC4R route. the setmélanotide has an “on-off” effect allowing a decrease in hyperphagia. an improvement in weight, and also the quality of life. “A recent study has shown that this molecule can be administered from the despite new drugs, global management new age of 2,” said Pre Dubern. The HAS opinion recommends its use only in specialized obesity centers, for genetic forms and Bardet-BIDL syndrome.
GLP-1 and other incretins …
“A multidisciplinary assessment remains essential,” insists the specialist. And despite new drugs, global management new for this drug to be effective. it is necessary to assess the eating behavior before. by asking specific questions. in particular thanks to questionnaires (such as the hyperphagia questionnaire of Dykens) despite new drugs, global management ”. The Setmélatide is available in early access under certain conditions and supported by Social Security. It is issued only in hospital pharmacy.
The pre Rachel Reynaud then made a point on the analogues of GLP-1. “They act on the brain. in terms of satiety centers, but also on the stomach, slowing down its emptying,” she explains. They also modify the release of glucagon and insulin. In pediatrics, Liraglutide despite new drugs, global management new has a Pediatric AMM for obesity.
“Recent publications in 2020. 2022. 2024 show an effectiveness of these molecules. the criterion to consider the drug as effective being a loss of more than 5 % of their weight. The Liraglutide. allowed 43 % in adolescents aged despite new drugs, global management new 12 to 18. treated to reach this loss after 56 weeks of follow-up and 26 weeks of coaching alone beforehand, ”she develops.
Nevertheless “in the placebo group. support alone has already allowed 19 % of despite new drugs. global management adolescents to lose more than 5 % of their weight,” said the specialist. This shows the importance of support backed by treatment. Some patients are not responders and this is visible from the 12th week of treatment. At the stop the weight recovery is fast. However. it recalls that the Liraglutide is not reimbursed currently. that its price is despite new drugs, global management new very variable depending on the pharmacies, from 180 to 250 euros.
As for the “star” molecule. the semaglutide. a study published in 2022 in pediatrics. over 12-18 years old, showed that 57 % of patients had a decrease of more than 15 % of the corpulence to 68 weeks of treatment, despite new drugs, global management new preceded by 12 weeks of coaching alone. Support allowed 23% of children on placebo to obtain weight loss of more than 5% and 5% a loss of more than 15%.
The undesirable effects (nausea. vomiting. diarrhea. abdominal pain) despite new drugs, global management were reported in around 40 % of treated patients (18 % for the placebo group) but led to stopping treatment in 2 % of cases.
“The European. French AMM for the semaglutide is currently reserved for adolescents over 12 years old with obesity. the weight of which is greater despite new drugs, global management new than 60 kg without reimbursement. All practitioners can prescribe it ”.
Despite new drugs, global management new
Despite new drugs, global management new
Despite new drugs. global management – Despite new drugs. global management
Patient -centered approach
Another medication. shooting, analogous of GLP1 and GLP, has shown drastic results in adults, but is only in the stage of phase III study in despite new drugs, global management new children, without publication for the moment.
“The prescription recommendations for the analogues of the GLP1 are an initiation with an approach centered on the patient. a revaluation of 12 weeks to find out if the drug is effective. a screening of nutritional anomalies from a weight loss of more than 10%. You also have despite new drugs, global management to pay attention to food preferences. because the patient is quickly satisfied, so you have to be vigilant to snacking, “she warns. It is despite new drugs, global management new also necessary to be able to accompany the patient on nutritional disorders. increase his physical activity to preserve his muscle and bone mass. “We must also find the optimal dose for these young patients, who is not necessarily the maximum dose,” she underlines.
For Pre Dubern, “we are at the dawn of new drugs. However, for obesity, the treatments are not magical. Global management remains important, ”she despite new drugs, global management new insists. And complex obesity requires specific care paths, in specialized centers.
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