Kumar, S

Objective: To examine changes in weight status after initiating zonisamide in children with epilepsy and elevated body mass index (BMI). Study Design: Retrospective chart review of children aged 2 to ≤18 years with epilepsy treated with zonisamide, assessing BMI changes over 2 years. Results: A total of 140 children were included; mean age (SD) at initiation was 9.60 years (3.93). BMI categories included 28 children with severe obesity, 28 with mild–moderate obesity, 28 with overweight, and 56 with healthy weight. Participants were 56.6% female, 91.4% non-Hispanic/Latino, and 88.6% White. At 2 years, BMI z score decreased significantly across all BMI groups: severe obesity −0.38 ( N = 13, 95% CI −0.64 to −0.13; p = 0.003), mild-moderate obesity −0.39 ( N = 15, 95% CI −0.62 to −0.16; p = 0.001), overweight −0.60 ( N = 14, 95% CI −0.84 to −0.36; p < 0.001), and healthy weight −0.46 ( N = 21, 95% CI −0.63 to −0.28; p < 0.001). Significant BMI z score reductions were also observed across age groups: 2–10 years −0.48 ( N = 40, 95% CI −0.62 to −0.34), >10–13 years −0.27 ( N = 15, 95% CI −0.50 to −0.04), and ≥13 years −0.63 ( N = 12, 95% CI 0.89 to −0.36). Conclusions: BMI reduction persisted up to 2 years following zonisamide initiation in children with epilepsy. Further prospective studies are needed to evaluate the weight loss effect and safety of zonisamide in children with epilepsy and elevated BMI.

ABSTRACT Considerable advances have been made in our understanding of Bardet–Biedl syndrome (BBS), particularly in its core clinical features and molecular genetics, warranting an update to the existing diagnostic criteria framework. Using a rigorous, evidence‐based, and consensus‐driven process, a multidisciplinary group of international experts and patient‐led organizations developed an updated diagnostic algorithm. This algorithm provides practical, updated guidance for clinicians, including a pathway for accurately incorporating genetic findings into the diagnostic process. We recommend that a clinical diagnosis requires either 4 major criteria or 3 major and 2 minor criteria. Revised major criteria are retinal dystrophy, obesity (or overweight in individuals < 2 years old), congenital anomalies of the kidney and urinary tract or chronic kidney disease, hypogonadism/genital anomalies, neurodevelopmental/neurocognitive manifestations, and postaxial polydactyly. The diagnosis can also be established with a positive genetic testing result in patients exhibiting ≥ 1 major criterion, provided that genetic findings should be interpreted in the context of the patient's clinical presentation, age, family history, and overlap with related ciliopathies. These consensus criteria offer a simple algorithm incorporating updated definitions for major and minor criteria and genetic testing to support a timely and accurate diagnosis of patients with BBS, inform genetic counseling, and potentially facilitate earlier access to treatment. Trial Registration: CRIBBS Registry; ClinicalTrials.gov : NCT02329210