Could setmelanotide be the game-changer for acquired hypothalamic obesity?
Children with acquired hypothalamic obesity, e.g. following treatment for pediatric craniopharyngioma are at great risk for metabolic syndrome, cardiovascular health problems and premature mortality. Treatment for acquired hypothalamic obesity has thus far been disappointing. Several interventions w...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Endocrinology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1307889/full |
| _version_ | 1797366766749351936 |
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| author | Hanneke M. van Santen Hanneke M. van Santen Christian Denzer Hermann Lothar Müller |
| author_facet | Hanneke M. van Santen Hanneke M. van Santen Christian Denzer Hermann Lothar Müller |
| author_sort | Hanneke M. van Santen |
| collection | DOAJ |
| description | Children with acquired hypothalamic obesity, e.g. following treatment for pediatric craniopharyngioma are at great risk for metabolic syndrome, cardiovascular health problems and premature mortality. Treatment for acquired hypothalamic obesity has thus far been disappointing. Several interventions were reported to be partially successful, including dextro-amphetamine and GLP-1R agonists, although results in acquired hypothalamic obesity are conflicting. Disruption of signaling through the melanocortin-4 receptor (MC4R) pathway results in hyperphagia and severe early-onset hypothalamic obesity. Recently, the MC4R agonist setmelanotide has shown promising results in children with genetic forms of hypothalamic obesity; POMC, PCSK1 and LEPR. Patient quotes such as “we have our family life back” illustrate the magnitude of the effect. Targeted hormone replacement therapy with a MC4R agonist for acquired hypothalamic obesity could be a game-changer. Preliminary results of setmelanotide treatment in 14, mostly pediatric, patients with acquired hypothalamic obesity are promising. The FDA has recommended that a prospective, randomized, blinded trial be conducted over a 12 months treatment period, comparable to pivotal trials for other obesity drugs. It may be discussed whether setmelanotide should be regarded as an obesity drug or whether it may be envisioned as an agent for hypothalamic substitution therapy. In this commentary we discuss the trial that is currently recruiting patients with acquired hypothalamic obesity. |
| first_indexed | 2024-03-08T17:08:07Z |
| format | Article |
| id | doaj.art-f68c5df2fc4946c09107afe2132b73d5 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-08T17:08:07Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-f68c5df2fc4946c09107afe2132b73d52024-01-04T04:29:09ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-01-011410.3389/fendo.2023.13078891307889Could setmelanotide be the game-changer for acquired hypothalamic obesity?Hanneke M. van Santen0Hanneke M. van Santen1Christian Denzer2Hermann Lothar Müller3Department of Pediatric Endocrinology, Princess Máxima Center for Pediatric Oncology, Utrecht, NetherlandsWilhelmina Children’s Hospital, University Medical center Utrecht (UMCU), Utrecht, NetherlandsDivision of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, GermanyUniversity Children’s Hospital, Carl von Ossietzky University Oldenburg, Klinikum Oldenburg AöR, Oldenburg, GermanyChildren with acquired hypothalamic obesity, e.g. following treatment for pediatric craniopharyngioma are at great risk for metabolic syndrome, cardiovascular health problems and premature mortality. Treatment for acquired hypothalamic obesity has thus far been disappointing. Several interventions were reported to be partially successful, including dextro-amphetamine and GLP-1R agonists, although results in acquired hypothalamic obesity are conflicting. Disruption of signaling through the melanocortin-4 receptor (MC4R) pathway results in hyperphagia and severe early-onset hypothalamic obesity. Recently, the MC4R agonist setmelanotide has shown promising results in children with genetic forms of hypothalamic obesity; POMC, PCSK1 and LEPR. Patient quotes such as “we have our family life back” illustrate the magnitude of the effect. Targeted hormone replacement therapy with a MC4R agonist for acquired hypothalamic obesity could be a game-changer. Preliminary results of setmelanotide treatment in 14, mostly pediatric, patients with acquired hypothalamic obesity are promising. The FDA has recommended that a prospective, randomized, blinded trial be conducted over a 12 months treatment period, comparable to pivotal trials for other obesity drugs. It may be discussed whether setmelanotide should be regarded as an obesity drug or whether it may be envisioned as an agent for hypothalamic substitution therapy. In this commentary we discuss the trial that is currently recruiting patients with acquired hypothalamic obesity.https://www.frontiersin.org/articles/10.3389/fendo.2023.1307889/fullhypothalamic obesityCraniopharyngiomaSetmelanotidebrain tumorobesity |
| spellingShingle | Hanneke M. van Santen Hanneke M. van Santen Christian Denzer Hermann Lothar Müller Could setmelanotide be the game-changer for acquired hypothalamic obesity? Frontiers in Endocrinology hypothalamic obesity Craniopharyngioma Setmelanotide brain tumor obesity |
| title | Could setmelanotide be the game-changer for acquired hypothalamic obesity? |
| title_full | Could setmelanotide be the game-changer for acquired hypothalamic obesity? |
| title_fullStr | Could setmelanotide be the game-changer for acquired hypothalamic obesity? |
| title_full_unstemmed | Could setmelanotide be the game-changer for acquired hypothalamic obesity? |
| title_short | Could setmelanotide be the game-changer for acquired hypothalamic obesity? |
| title_sort | could setmelanotide be the game changer for acquired hypothalamic obesity |
| topic | hypothalamic obesity Craniopharyngioma Setmelanotide brain tumor obesity |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1307889/full |
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