Author Affiliations: National Drug and Poison Information Center, Saudi Food and Drug Authority, Riyadh, Saudi Arabia.
Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
Although the Glaser Pediatric Research Network Obesity Study Group1 appropriately calls for more research on the long-term use of metformin, we are concerned that the door continues to be open for the off-label prescribing of metformin, with potential harms outweighing any demonstrated long-term benefit in the treatment of adolescent obesity. In their study, the authors reported that at the end of 48 weeks, the adjusted body mass index (BMI) mean was increased by 0.2 in the control group and decreased by 0.9 in the metformin extended release (XR) group, and the difference in favor of metformin persisted for 12 to 24 weeks after treatment cessation. Our analysis of the primary end point at 48 rather than 24 weeks after treatment cessation indicates a greater benefit for the lifestyle intervention compared with metformin treatment. As shown in Table 2, after 48 weeks of treatment cessation, the adjusted BMI mean was decreased by 0.8 in the control group and increased by 0.6 in the metformin XR group (P = .02). The differences from baseline was −0.7 and −0.3, respectively.
It should be noted that metformin has been tested comparing the drug with lifestyle intervention in the prevention of type 2 diabetes in adults. Both interventions were positive, with the lifestyle intervention being more effective than metformin.2 In the absence of evidence of a benefit with metformin treatment for a clinically meaningful outcome, physicians should encourage lifestyle modification over pharmacotherapy for adolescent obesity.
Correspondence: Dr Sukkari, National Drug and Poison Information Center, Saudi Food and Drug Authority, 3292 Northern Ring Rd, Riyadh 13312-6288, Saudi Arabia (srsukkari.c@sfda.gov.sa).
Author Contributions:Study concept and design: Sukkari and Humaidan. Acquisition of data: Sukkari. Analysis and interpretation of data: Sukkari, Sasich, Humaidan, and Burikan. Drafting of the manuscript: Sukkari, Sasich, and Humaidan. Critical revision of the manuscript for important intellectual content: Sukkari, Sasich, Humaidan, and Burikan. Statistical analysis: Sukkari. Administrative, technical, and material support: Sukkari, Sasich, Humaidan, and Burikan. Study supervision: Sukkari and Sasich.
Financial Disclosure: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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