Background: Hypothalamic obesity (HO) is a severe, often treatment-refractory complication after craniopharyngioma (CP) surgery. Setmelanotide, a melanocortin-4 receptor agonist (MC4R-A), offers a targeted therapeutic approach, but real-world data are limited. Methods: We performed a retrospective review of patients with post-CP HO treated with setmelanotide at our center, collecting clinical, metabolic, and treatment-related data. Results: Three young adults with HO after surgery for CP were included. Treatment responses were variable: one patient discontinued setmelanotide after continued weight gain, while two experienced reductions in weight, BMI, waist circumference, triglycerides and insulin levels over 6–9 months. Adverse effects were mild and non-limiting. Conclusion: Setmelanotide may provide meaningful benefit for selected patients with severe, treatment-refractory HO after CP. Despite small sample size, this series supports further investigation of MC4R agonism as a targeted therapy for acquired HO.
Safety and effectiveness of setmelanotide in young patients with severe obesity due to craniopharyngioma: a real world monocentric experience
Angileri F.;
2026-01-01
Abstract
Background: Hypothalamic obesity (HO) is a severe, often treatment-refractory complication after craniopharyngioma (CP) surgery. Setmelanotide, a melanocortin-4 receptor agonist (MC4R-A), offers a targeted therapeutic approach, but real-world data are limited. Methods: We performed a retrospective review of patients with post-CP HO treated with setmelanotide at our center, collecting clinical, metabolic, and treatment-related data. Results: Three young adults with HO after surgery for CP were included. Treatment responses were variable: one patient discontinued setmelanotide after continued weight gain, while two experienced reductions in weight, BMI, waist circumference, triglycerides and insulin levels over 6–9 months. Adverse effects were mild and non-limiting. Conclusion: Setmelanotide may provide meaningful benefit for selected patients with severe, treatment-refractory HO after CP. Despite small sample size, this series supports further investigation of MC4R agonism as a targeted therapy for acquired HO.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
