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Case report: Metreleptin rapidly improved anorexia nervosa related and comorbid psychopathology in a patient with high endogenous leptin levels adjusted for body mass index.

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Title: Case report: Metreleptin rapidly improved anorexia nervosa related and comorbid psychopathology in a patient with high endogenous leptin levels adjusted for body mass index.
Authors: Antel, Jochen (AUTHOR), Gradl-Dietsch, Gertraud (AUTHOR), Peters, Triinu (AUTHOR), Pridzun, Lutz (AUTHOR), Degenhardt, Franziska (AUTHOR), von Piechowski, Linda (AUTHOR), Hinney, Anke (AUTHOR), Hebebrand, Johannes (AUTHOR)
Source: European Child & Adolescent Psychiatry. Oct2025, Vol. 34 Issue 10, p3307-3315. 9p.
Subjects: Off-label use (Drugs), Post-traumatic stress disorder, Self-injurious behavior, Self-evaluation, Physical diagnosis, Weight loss, Leptin, Body mass index, Parenteral feeding, Insomnia, Patient readmissions, Treatment effectiveness, Affective disorders, Severity of illness index, Enzymes, Obsessive-compulsive disorder, Clinical pathology, Anorexia nervosa, Food habits, Recombinant proteins, Sleep quality, Synthetic drugs, Tachycardia, Liver, Comorbidity, Pathological psychology, Mental depression, Weight gain, Amenorrhea, Evaluation, Therapeutics
Abstract: Off-label treatment of a 17-year-old female patient with anorexia nervosa (AN), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and non-suicidal self-injury (NSSI) with human recombinant leptin (metreleptin) for two dosing periods of 15 and seven days was associated with self- and clinician-rated improvements of eating disorder related psychopathology, OCD, depression, and NSSI. These intermittent improvements occurred despite the patient having high endogenous serum leptin levels ranging up to the 99th centile adjusted for sex, Tanner stage and body mass index (BMI; kg/m²) upon initiation of dosing. The results further extend the hypothesized effects of metreleptin on AN and comorbid psychopathology to patients with adjusted leptin levels in the normal to high range. We hypothesize that for unknown reasons the clinical symptomatology of a subgroup of patients with AN persists despite attainment of endogenous leptin levels well above those characteristic of the state of starvation, potentially entailing a prolonged entrapment in the eating disorder. An insight into the mechanisms underlying this distinct type of leptin resistance may help to promote recovery of such affected patients. Placebo controlled randomized clinical trials are required to assess if and to what extent short and medium term metreleptin treatment indeed improves recovery. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Case report: Metreleptin rapidly improved anorexia nervosa related and comorbid psychopathology in a patient with high endogenous leptin levels adjusted for body mass index.
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  Data: <searchLink fieldCode="AR" term="%22Antel%2C+Jochen%22">Antel, Jochen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gradl-Dietsch%2C+Gertraud%22">Gradl-Dietsch, Gertraud</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Peters%2C+Triinu%22">Peters, Triinu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pridzun%2C+Lutz%22">Pridzun, Lutz</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Degenhardt%2C+Franziska%22">Degenhardt, Franziska</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22von+Piechowski%2C+Linda%22">von Piechowski, Linda</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hinney%2C+Anke%22">Hinney, Anke</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hebebrand%2C+Johannes%22">Hebebrand, Johannes</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Oct2025, Vol. 34 Issue 10, p3307-3315. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Off-label+use+%28Drugs%29%22">Off-label use (Drugs)</searchLink><br /><searchLink fieldCode="DE" term="%22Post-traumatic+stress+disorder%22">Post-traumatic stress disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Self-injurious+behavior%22">Self-injurious behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Self-evaluation%22">Self-evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+diagnosis%22">Physical diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Weight+loss%22">Weight loss</searchLink><br /><searchLink fieldCode="DE" term="%22Leptin%22">Leptin</searchLink><br /><searchLink fieldCode="DE" term="%22Body+mass+index%22">Body mass index</searchLink><br /><searchLink fieldCode="DE" term="%22Parenteral+feeding%22">Parenteral feeding</searchLink><br /><searchLink fieldCode="DE" term="%22Insomnia%22">Insomnia</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+readmissions%22">Patient readmissions</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Affective+disorders%22">Affective disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+of+illness+index%22">Severity of illness index</searchLink><br /><searchLink fieldCode="DE" term="%22Enzymes%22">Enzymes</searchLink><br /><searchLink fieldCode="DE" term="%22Obsessive-compulsive+disorder%22">Obsessive-compulsive disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+pathology%22">Clinical pathology</searchLink><br /><searchLink fieldCode="DE" term="%22Anorexia+nervosa%22">Anorexia nervosa</searchLink><br /><searchLink fieldCode="DE" term="%22Food+habits%22">Food habits</searchLink><br /><searchLink fieldCode="DE" term="%22Recombinant+proteins%22">Recombinant proteins</searchLink><br /><searchLink fieldCode="DE" term="%22Sleep+quality%22">Sleep quality</searchLink><br /><searchLink fieldCode="DE" term="%22Synthetic+drugs%22">Synthetic drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Tachycardia%22">Tachycardia</searchLink><br /><searchLink fieldCode="DE" term="%22Liver%22">Liver</searchLink><br /><searchLink fieldCode="DE" term="%22Comorbidity%22">Comorbidity</searchLink><br /><searchLink fieldCode="DE" term="%22Pathological+psychology%22">Pathological psychology</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Weight+gain%22">Weight gain</searchLink><br /><searchLink fieldCode="DE" term="%22Amenorrhea%22">Amenorrhea</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation%22">Evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
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  Data: Off-label treatment of a 17-year-old female patient with anorexia nervosa (AN), major depressive disorder (MDD), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and non-suicidal self-injury (NSSI) with human recombinant leptin (metreleptin) for two dosing periods of 15 and seven days was associated with self- and clinician-rated improvements of eating disorder related psychopathology, OCD, depression, and NSSI. These intermittent improvements occurred despite the patient having high endogenous serum leptin levels ranging up to the 99th centile adjusted for sex, Tanner stage and body mass index (BMI; kg/m²) upon initiation of dosing. The results further extend the hypothesized effects of metreleptin on AN and comorbid psychopathology to patients with adjusted leptin levels in the normal to high range. We hypothesize that for unknown reasons the clinical symptomatology of a subgroup of patients with AN persists despite attainment of endogenous leptin levels well above those characteristic of the state of starvation, potentially entailing a prolonged entrapment in the eating disorder. An insight into the mechanisms underlying this distinct type of leptin resistance may help to promote recovery of such affected patients. Placebo controlled randomized clinical trials are required to assess if and to what extent short and medium term metreleptin treatment indeed improves recovery. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00787-025-02809-3
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        Text: English
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      – SubjectFull: Off-label use (Drugs)
        Type: general
      – SubjectFull: Post-traumatic stress disorder
        Type: general
      – SubjectFull: Self-injurious behavior
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      – SubjectFull: Self-evaluation
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      – SubjectFull: Physical diagnosis
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      – SubjectFull: Weight loss
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      – SubjectFull: Leptin
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      – SubjectFull: Body mass index
        Type: general
      – SubjectFull: Parenteral feeding
        Type: general
      – SubjectFull: Insomnia
        Type: general
      – SubjectFull: Patient readmissions
        Type: general
      – SubjectFull: Treatment effectiveness
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      – SubjectFull: Affective disorders
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      – SubjectFull: Enzymes
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      – SubjectFull: Anorexia nervosa
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      – SubjectFull: Food habits
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      – SubjectFull: Recombinant proteins
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      – SubjectFull: Synthetic drugs
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      – SubjectFull: Liver
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      – SubjectFull: Weight gain
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      – SubjectFull: Evaluation
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      – SubjectFull: Therapeutics
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      – TitleFull: Case report: Metreleptin rapidly improved anorexia nervosa related and comorbid psychopathology in a patient with high endogenous leptin levels adjusted for body mass index.
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