Real-World Use of Subsidised Semaglutide in Icelandic Children With Obesity: A Nationwide Retrospective Cohort Study

IF 2.5 3区医学 Q1 PEDIATRICS

Pediatric Obesity Pub Date : 2026-08-02 DOI:10.1111/ijpo.70139

Sigrun Thorsteinsdottir, Berglind Jonsdottir, Anna S. Olafsdottir, Helena B. Arnarsdottir, Sigrun Hallgrimsdottir, Berglind Brynjólfsdóttir, Tryggvi Helgason

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引用次数: 0

Abstract

Background

Real-world evidence of subsidised semaglutide in children with obesity is scarce.

Objectives

To describe clinical outcomes (%IOTF30 change) in a nationwide cohort of Icelandic children prescribed subsidised semaglutide, describing outcomes across treatment settings and examining treatment response in children with and without neurodevelopmental disorders (ND).

Methods

Retrospective, population-based cohort study using longitudinal anthropometric measurements, March 20, 2021–June 6, 2025. Children aged ≥ 12 with grade 2 obesity were eligible for subsidised semaglutide under a universal reimbursement policy. Main outcomes were changes in %IOTF30 (BMI expressed as a percentage of the age- and sex-specific IOTF obesity threshold), modelled using piecewise linear mixed-effects regression.

Results

Among 113 participants (44% female; mean [SD] age 15.2 [2.0] years), pre-treatment %IOTF30 rose at 0.29 percentage points (pp)/month (95% CI, 0.26, 0.33). Semaglutide was associated with trajectory reversal at −0.86 pp/month (95% CI, −1.06 to −0.66); estimated reductions were 5.17 (95% CI, 3.98, 6.36) and 10.33 (95% CI, 7.96, 12.71) pp at six and 12 months. On-treatment slopes were numerically similar across settings but not interpretable as evidence of equivalent response. ND-status did not significantly modify treatment response among 56 Pediatric Obesity Center participants (interaction p = 0.83; underpowered). Overall, 63% achieved %IOTF30 reductions exceeding 10 pp.

Conclusions

Semaglutide was associated with reversal of a longstanding upward weight trajectory in children with obesity. ND-status did not significantly modify treatment response; analysis was underpowered. Universal subsidisation policy enabled high treatment persistence and may inform reimbursement policy in other countries, though generalisability to settings without universal coverage remains uncertain.

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冰岛儿童肥胖患者使用补贴的西马鲁肽：一项全国性的回顾性队列研究。

背景：实际证据表明，补贴的西马鲁肽治疗儿童肥胖很少。目的：描述冰岛儿童在全国范围内服用补贴的西马鲁肽的临床结果（%IOTF30变化），描述治疗设置的结果，并检查有无神经发育障碍（ND）儿童的治疗反应。方法：回顾性、基于人群的队列研究，采用纵向人体测量，研究时间为2021年3月20日至2025年6月6日。年龄≥12岁的2级肥胖儿童在普遍报销政策下有资格获得补贴的西马鲁肽。主要结果是IOTF30 %的变化（BMI以年龄和性别特异性IOTF30肥胖阈值的百分比表示），采用分段线性混合效应回归建模。结果：在113名参与者中（44%为女性，平均[SD]年龄15.2[2.0]岁），治疗前%IOTF30上升0.29个百分点(pp)/月（95% CI, 0.26, 0.33）。Semaglutide与-0.86 pp/月的轨迹逆转相关（95% CI, -1.06至-0.66）；估计在6个月和12个月时分别减少5.17 （95% CI, 3.98, 6.36）和10.33 （95% CI, 7.96, 12.71）个百分点。处理后的斜率在数值上是相似的，但不能解释为等效反应的证据。在56名儿童肥胖中心的参与者中，nd状态没有显著改变治疗反应（相互作用p = 0.83；动力不足）。总体而言，63%的人实现了超过10个百分点的IOTF30减少。结论：Semaglutide与肥胖症儿童长期体重上升趋势的逆转有关。nd状态对治疗反应没有显著影响；分析不够有力。普遍补贴政策使治疗的持久性得以提高，并可能为其他国家的报销政策提供参考，尽管在没有普遍覆盖的情况下的普遍性仍不确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.