Treatment with glucagon-like Peptide-1 agonist exendin-4 in a patient with hypothalamic obesity secondary to intracranial tumor

Horm Res Paediatr. 2012;78(1):54-8. doi: 10.1159/000339469. Epub 2012 Jul 20.

Abstract

Background/aims: Patients with hypothalamic tumors frequently experience severe obesity, and its treatment with diet, exercise, and/or pharmacologic treatment has had limited effect. Glucagon-like peptide-1 agonist exenatide (exendin-4), used for treatment of type 2 diabetes, causes persistent weight loss via signaling in the brainstem.

Methods: We report the case of a 17-year-old patient with obesity resulting from a hypothalamic germ cell tumor. He was treated by chemoradiotherapy and exenatide at a dose of 5 µg subcutaneously twice daily.

Results: Exenatide resulted in a 29-kg weight loss (BMI reduction from 37.1 to 29.1) after 2.5 years of treatment; significant weight gain occurred shortly after exenatide was discontinued.

Conclusion: Exenatide resulted in considerable reduction of body weight in a patient with severe hypothalamic obesity. This novel observation requires follow-up clinical studies for establishing the effects of exenatide in patients with disrupted hypothalamic energy regulatory pathways.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Brain Neoplasms / complications*
  • Brain Neoplasms / drug therapy
  • Exenatide
  • Glucagon-Like Peptide 1 / agonists
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Hypothalamic Neoplasms / complications
  • Hypothalamic Neoplasms / drug therapy
  • Male
  • Neoplasms, Germ Cell and Embryonal / complications*
  • Neoplasms, Germ Cell and Embryonal / drug therapy
  • Obesity / drug therapy*
  • Obesity / etiology*
  • Peptides / therapeutic use*
  • Venoms / therapeutic use*

Substances

  • Hypoglycemic Agents
  • Peptides
  • Venoms
  • Glucagon-Like Peptide 1
  • Exenatide