GLP-1 receptor agonist use in children and adolescents with obesity or type 2 diabetes was associated with a lower risk of suicidal ideation or behaviors than metformin (HR 0.11; 95% CI 0.02-0.86).
Cohort (n=2,010)
Yes
Does GLP-1 RA use reduce the risk of suicidal ideation/behaviors, depression, and anxiety in children and adolescents with obesity or youth-onset type 2 diabetes compared to metformin?
In children and adolescents with obesity or type 2 diabetes, GLP-1 receptor agonist use is associated with a significantly lower risk of suicidal ideation/behaviors and depression compared to metformin use.
Hazard Ratio: 0.11 (95% CI 0.02–0.86)
Introduction and Objective: Rising rates of obesity and youth-onset type 2 diabetes (YT2D) among children and adolescents have increased GLP-1 receptor agonist (GLP-1 RA) use, raising concerns about potential effects on suicidal ideation/behaviors (SI/SB), depression, and anxiety. Therefore, we aimed to assess associations between GLP-1 RA use for obesity or YT2D and risk of SI/SB, depression, and anxiety in children and adolescents. Methods: This retrospective cohort study used electronic health record data from the OneFlorida+ Clinical Research Network from January 1, 2020, through January 31, 2024, using a target trial emulation approach with a prevalent-new user design. The study included children and adolescents aged 6 to younger than 18 years with obesity or YT2D and no prior history of the outcomes of interest at baseline. New users of GLP-1 RAs were compared with prevalent users of metformin. Confounding was addressed using stabilized inverse probability of treatment weighting. Weighted Cox proportional hazards models were used to estimate hazard ratios and risk differences (RDs) for suicidal ideation or behavior, anxiety, and depression. RDs were reported per 1,000 person-years, with 95% confidence intervals. Results: The study included 2,010, 1,774, and 1,764 patients for SI/SB, depression, and anxiety, respectively. The mean age was ~14.2 years, ~61% were female, with up to 4 years of follow-up, across cohorts. Compared to prevalent metformin users, GLP-1 RA users had a lower incidence and risk of SI/SB (RD: -10.45, -14.54 to -6.36; HR: 0.11, 0.02 to 0.86) and depression (RD: -25.64, -34.90 to -16.39; HR: 0.37, 0.17 to 0.78). There was no difference in anxiety risk between the two groups (RD: 5.95, -7.10 to 19.01; HR: 1.13, 0.69 to 1.84). Conclusion: GLP-1 RA use may reduce the risks of SI/SB and depression among children and adolescents with obesity or YT2D; no significant association was found for anxiety. Long-term surveillance is needed in this vulnerable population. Disclosure P. Kotecha: Employee; Ended; Merck Current; Lilly. S. Westen: None. S.M. Smith: None. P. Zhang: None. T.S. Hannon: None. J. Bian: None. S. Guo: None. Funding NIH/NIDDK (R01DK133465)
Kotecha et al. (Fri,) conducted a cohort in Obesity or youth-onset type 2 diabetes (n=2,010). GLP-1 receptor agonists vs. Metformin was evaluated on Suicidal ideation or behavior (SI/SB) (HR 0.11, 95% CI 0.02 to 0.86). GLP-1 receptor agonist use in children and adolescents with obesity or type 2 diabetes was associated with a lower risk of suicidal ideation or behaviors than metformin (HR 0.11; 95% CI 0.02-0.86).