Introduction Hypothalamic obesity (HO) is an intractable form of obesity caused by different etiologies both genetic and acquired disorders. Somatostatin analogues (SA) therapy have been described with efficacy and high safety profile in patients with neuroendocrine and pituitary diseases in the adult. Only few clinical trials reported the effect of SA in the pediatric population with HO and all were of short duration. Objectives:To assess the long term effects of SA therapy among children and youth with HO.Design and methods This is an observational retrospective multi-center study which included 6 medical centers in Israel. Primary outcome: safety parameters, delta BMI(SDS) and height (SDS) . Secondary outcome: changes in metabolic and laboratory parameters following SA therapy.Results: Study population included 11 patients (7 males), median age 16 years (range 9-20.4), 5 of them were fully pubertal. The etiologies of HO included 9 subjects after surgery for ֲ Craniopharyngioma (6) ֲ ֲ Astrocytoma (2) and Ependimoma (1), 1 patient with ROHHAD syndrome, and 1 with Hypothalamic Cortical Dysplasia . Median duration of treatment was 18 months (range 12-61). BMI (SDS) decreased significantly following SA therapy by -0.5 SDS (range -0.58 to -0.3)ֲ ,(p =0.017). There was no significant decrease ֲ in height median change 0 SDS (range-0.19- 0.6), and no differences in all the other parameters including pubertal progression and metabolic parameters following SA therapy.Conclusion ֲ Therapy with SA is effective therapy in the attenuation of weight increase in pediatric patients with HO ,without decrease in growth rate and without ֲ metabolic abnormalities.
