Effects of anti-obesity drugs on cardiometabolic risk factors in pediatric population with obesity: a systematic review and meta-analysis of randomized controlled trials.

Following prospective registration (PROSPERO CRD42024564275), three databases (PubMed, SCOPUS, Web of Science) were searched for trials reporting the effects of anti-obesity drugs (AODs) (with placebo as control) on cardiometabolic risk factors in the pediatric population with obesity. Data was synthesized using RStudio within a Random effect model. Risk of Bias was assessed through the Cochrane Risk of Bias 2 tool. Five clinical trials fulfilled the eligibility criteria. Pooled estimates showed significant reductions in triglycerides [-13.84 mg/dl (CI: -26.46 to -1.21; p 0.03) (I² 93 %, p<0.01), Systolic blood pressure [-1.49 mmHg (CI: -2.77 to -0.21; p 0.02) (I² 0 %, p 0.61)], and Waist circumference [-6.55 cm (CI: -10.56 to -2.55; p<0.01) (I² 93 %, p<0.01)]. Fasting glucose, Insulin, Insulin resistance, Glycated hemoglobin, Diastolic blood pressure, Total cholesterol, Low density lipoproteins, High density lipoproteins, Very low density lipoproteins, and C-Reactive Protein showed insignificant reductions. No significant publication bias was detected in any outcome except Waist circumference (p 0.03).