Anti-obesity drug prescribing in children and adolescents: a population-based study in the UK

Abstract

Aim/Objectives: To investigate prescribing patterns of anti-obesity drugs (orlistat and sibutramine) to children and adolescent aged 0-18 years in the UK. Methods: Using the UK General Practice Research Database (GPRD), we carried out a retrospective cohort study between January 1999 and December 2006. The cohort comprised of all children and adolescents aged 0-18 years who received at least one antiobesity drug prescription. The overall, age, and sex-specifi c prevalence of prescribing was calculated. The duration of anti-obesity drug treatment was also analysed. Treatment was considered as stopped if there were no further prescriptions issued within 90 consecutive days after the date of the last prescription. The Kaplan-Meier survival analysis was used to investigate treatment duration. Results: A total of 452 subjects received 1333 prescriptions during the study period. The annual prevalence of anti-obesity drug prescriptions rose signifi cantly from 0.006 per 1000 (95 % CI :0.0007-0.0113) in 1999 to 0.091 per 1000 (95% CI: 0.07- 0.11) in 2006; a 15-fold increase. The sex-specifi c prevalence was signifi cantly increasing in both boys and girls over the study period (p<0.05). The use of orlistat accounted for the majority of anti-obesity drug prescriptions (78.4%). The mean duration of orlistat use was signifi cantly shorter (3.0 months; 95%CI: 2.72 to 3.47) compared with sibutramine (4.2 months; 95%CI: 3.4 to 5.0) (p=0.003). Approximately 45% of orlistat prescriptions were discontinued within the fi rst month and about 25% of sibutramine prescriptions were discontinued within the fi rst month. Conclusion: Prescribing of anti-obesity drugs in young people has dramatically increased during past few years. However, the majority of prescriptions are rapidly discontinued during the fi rst 3 months, suggesting tolerability and effectiveness may be low in routine clinical use. Further research into the effectiveness and safety of anti-obesity drugs in children and adolescents in a clinical population is needed.