Recruiting nowPhase 2Interventional
What this study is about
This is a phase 2 randomized placebo-controlled crossover trial to determine the safety and efficacy of atomoxetine for treating obesity caused by loss-of-function variants in the melanocortin-4 receptor (MC4R), the most common cause of genetic obesity disorders. Atomoxetine was selected for this pilot trial because it has been shown to increase brain-derived neurotrophic factor (BDNF) within the central nervous system and in peripheral circulation. Targeting BDNF is a specific strategy for treating MC4R abnormalities because BDNF functions as a downstream mediator of MC4R signaling.
A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.
Basic eligibility
Age6 Years to Not listed
SexAll
Healthy volunteersNot accepted
ConditionMelanocortin Obesity Syndrome, MCOS
Full registry criteria
Inclusion criteria: * Age 6 years and above * Documented MC4R variant classified as pathogenic, likely pathogenic, or variant of uncertain significance per ACMG criteria. If testing was done in a research lab, it will be confirmed by a CLIA-approved lab prior to randomization. * Obesity defined as BMI ≥30 kg/m2 in adults or ≥95th percentile for age and sex in children Exclusion criteria: * Use of atomoxetine, viloxazine (another selective norepinephrine-reuptake inhibitor), methylphenidate, amphetamine, dextroamphetamine, lisdexamfetamine, phentermine, or any other stimulant medication in the past 30 days. If on other ADHD medications, such as guanfacine and clonidine, must be on a stable dose for \>3 months. * Weight loss \>5% in the past 3 months. * Initiation of new weight loss program, including diet or medications. If on weight loss medications, must be on a stable dose for \>3 months. * Inability to swallow capsules. * History of hypersensitivity to atomoxetine. * Narrow angle glaucoma. * History of pheochromocytoma. * Uncontrolled Stage 2 hypertension (≥95th percentile + 12 mmHg or \>140/90, whichever is lower) at screening. If on antihypertensive medication, must be on stable dose for \>3 months. * Hepatic insufficiency including cirrhosis and acute hepatitis (AST or ALT \>3x upper limit of normal) * Uncontrolled asthma requiring albuterol more than once weekly over the past 3 months * History of a cardiac arrhythmia (not including bradycardia) * Current use of monoamine oxidase inhibitors * Pregnancy or intention to become pregnant during the next year * History of Major Depressive Disorder in the past 2 years, lifetime history of suicide attempt, history of any suicidal behavior in the past month, history of other severe psychiatric disorders (e.g. schizophrenia, bipolar disorder) * PHQ-9 score is ≥15 or suicidal ideation of type 4 or 5 (C-SSR) in the past month * Unable to comply with study procedures in the opinion of the investigator
