Treatment with sodium oxybate in children with type 1 narcolepsy (NT1) is associated with weight loss, according to the study results published in Sleep, which stabilizes after two years of therapy.
Overweight and obesity are common in children with NT1, placing patients at increased risk of cardiovascular complications and decreased quality of life. Previous studies reported that sodium oxybate treatment was associated with weight loss in adults with NT1. With limited data on the effect of sodium oxybate on child weight, the aim of the current study was to determine the effects on body mass index (BMI) in pediatric NT1.
This retrospective study included 129 NT1 patients (26.4% obese; 29.5% overweight). Of these, 50 patients (mean age 12 years; 52% girls; mean BMI Z-score 1.2) received sodium oxybate as monotherapy, 30 patients (mean age 12.3 years; 50% girls; mean BMI Z-score 1.4 ) were treated with sodium oxybate in combination with additional therapy, and 49 patients (mean age 11.7 years; 42.9% girls; mean BMI Z-score 0.7) were not treated with sodium oxybate.
After 1 year, a significant reduction in the BMI-Z-score was documented in patients who received sodium oxybate as monotherapy (mean BMI-Z-score 0.4; P <0.001) or in combination with other therapies (mean BMI-Z-score 1.0; P =) were treated .002). After 2 years, only patients in the combination therapy group reported a significant reduction in BMI-z (from 1.0 to 0.6, P = 0.037). The weight stabilized after 2 years of sodium oxybate therapy.
The adjusted beta coefficients of sodium oxybate monotherapy compared to other therapies were -0.82 (95% CI, -1.14 to -0.51; P <0.001) and the beta coefficients of sodium oxybate as part of combination therapy were im Compared to other therapies -0.56 (95% CI, -0.92 to -0.19; P = 0.003).
On the other hand, in children not treated with sodium oxybate, significant weight gain was reported during the follow-up period, particularly between years 2 and 3 of therapy (BMI Z-Score increased from 0.3 to 0.5; P = 0.037 ).
The study had several limitations, including its retrospective design, loss of patients during follow-up care, and the lack of data on effectiveness for NT1 symptoms and side effects on treatments.
“IN ORDER TO [sodium oxybate] was associated with significant weight loss in the first year of treatment in a retrospective cohort of consecutive NT1 children and adolescents, an effect which, given the dramatic comorbidity of overweight / obesity in NT1, especially in childhood, can be considered beneficial and not detrimental ” , Concluded the study researchers.
Ponziani V, Pizza F, Zenesini C, Vignatelli L, Pession A, Plazzi G. BMI changes in pediatric type 1 narcolepsy with sodium oxybate treatment. Sleep. Published online January 3, 2021. doi: 10.1093 / sleep / zsaa295