Appetite stimulants for people with cystic fibrosis

McTavish, Diane; Thornton, Judith

doi:10.1002/14651858.cd008190.pub3

Cited by 3 publications

(4 citation statements)

References 126 publications

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“…No difference in change in pulmonary function was observed. The authors were unable to assess for adverse events because they were not sufficiently reported (10). A randomized, controlled trial comparing cyproheptadine to placebo for appetite stimulation in 25 pediatric pwCF found improvements in weight after 3 months of therapy with cyproheptadine use but no significant change in pulmonary function.…”

Section: Discussionmentioning

confidence: 99%

“…Medication therapies that can be used for appetite stimulation include cyproheptadine, dronabinol, megestrol, and mirtazapine. Of the aforementioned agents, only cyproheptadine and megestrol have been studied in CF patients; however, the studies describing their use are limited to a small number of patients (9)(10)(11). To our knowledge, no published literature currently exists evaluating the use of mirtazapine in the pediatric CF population, and no published literature exists evaluating the use of more than 1 appetite stimulant in a single patient population.…”

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confidence: 99%

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Evaluation of the Use of Appetite Stimulants in Pediatric Patients with Cystic Fibrosis

Kennedy

Lee

Sathe

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objective: Poor nutrition in patients with cystic fibrosis (CF) has been associated with lower lung function and increased morbidity and mortality. Conversely, better nutritional status has been associated with improved pulmonary function and fewer CF-associated complications. There is no consensus regarding appetite stimulant therapy in patients with CF (pwCF). The primary objective of this study was to determine if the use of appetite stimulants was associated with weight changes in pediatric pwCF in the ambulatory care setting. Methods: This was a retrospective study that evaluated 62 pediatric pwCF who received cyproheptadine or mirtazapine for appetite stimulation for at least 6 consecutive months. Weight z-scores were collected for each patient at baseline, 3, 6, and 12 months of therapy, if available. Results: Increase in weight z-score after 3 months of therapy was statistically significant based on both univariable and multivariable models when evaluating the entire cohort. The adjusted mean difference for change in weight z-score was 0.33 (p< 0.001) from baseline to month 3. There was a statistically significant improvement in pulmonary function after 3 and 6 months of therapy. Conclusions: Appetite stimulant therapy is associated with improvement in weight z-score in the first 3 months of treatment. Appetite stimulant therapy was associated with improvement in pulmonary function in the first 3 months of therapy, which supports the relationship between weight gain and improved pulmonary function in pwCF. These findings suggest that appetite stimulants contribute to weight gain in pediatric pwCF, particularly within the first 3 months of therapy.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluation of the Use of Appetite Stimulants in Pediatric Patients with Cystic Fibrosis

Kennedy

Lee

Sathe

et al. 2023

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…prompting, coaxing, commanding) in order to address eating difficulties in their children ( Stark & Powers, 2005 ). However, while the importance of eating behaviors is established in children and adults with CF, research regarding appetitive characteristics-enduring dispositions towards food (food approach and food avoidance tendences; ( Carnell & Wardle, 2008 ) that have been shown in healthy children to track through development ( Ashcroft, Semmler, Carnell, van Jaarsveld, & Wardle, 2008 ; Jansen, Thapaliya, et al, 2023 ) and show genetic influence ( Carnell, Haworth, Plomin, & Wardle, 2008 ; Llewellyn, Van Jaarsveld, Johnson, Carnell, & Wardle, 2010 )- is relatively underdeveloped, and there is no consensus on an objective method of assessing appetite in CF ( McTavish & Thornton, 2022 ). In a previous study we validated the Child Eating Behavior Questionnaire (CEBQ; Carnell & Wardle, 2007 ; Wardle, Guthrie, Sanderson, & Rapoport, 2001 ) in parents of children aged 2–12 years with CF and found that children with CF had lower scores on appetite in association with lower weight, and as compared to children ( Papantoni et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Parental perceptions of body weight and appetite in infants and toddlers with cystic fibrosis

Duck,

Jansen,

Papantoni

et al. 2024

Appetite

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“…Therefore, its antiserotoninergic effect can explain the increase in appetite and weight gain. This also justifies its interest as an appetite stimulant, especially in cases of cystic fibrosis [1,6,7]. This drug is also indicated for treatment of allergic conditions such as urticaria, angioedema, rhinitis, conjunctivitis, and pruritic skin disorders [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

A novel compounded cyproheptadine hydrochloride oral solution: Accelerated stability study and effects on glucose and lipid metabolism in Wistar rats

Ferreira da Costa,

Silveira Cunha,

Gordilho

et al. 2024

Sci. Plena

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The present study developed a compounded oral solution (COS) containing an active component cyproheptadine hydrochloride (CY) in association with pharmaceutical adjuvants. The main objective is to demonstrate the stability of this solution and the in vivo effects on serum and liver parameters of glucose and lipid metabolism. After 180 days of analysis the COS showed physicochemical stability (pH and specific gravity) when submitted to different temperatures (24 °C and 40 °C), but the chemical stability, presented by the content of CY (%) in the formulation, showed that the degradation rate of CY increased 20x when submitted to a stress condition (40 °C). Male Wistar rats were treated with IOS 1.5 (industrial oral solution 1.5 mg.kg-1) or saline for 21 days and IOS 5.0 or COS (5 mg.kg-1) or placebo by gavage for 23 days. Treatment with IOS 1.5 increased liver cholesterol by 30 % without changing liver and body weight in this group. In contrast, treatment with IOS and COS (5 mg.kg-1) increased final body weight by 8 % compared to placebo. Interestingly, the COS group had increased liver glycogen accompanied by reduced food intake compared to IOS. However, COS and IOS 5.0 did not induce changes in adipose tissue weight, liver weight, as well as serum glucose, triacylglycerol and cholesterol levels. This work provides us with data that prove the stability of the compound solution at room temperature, as well as inducing an increase in the final body weight of rats with no alteration in glucose and lipid metabolism.

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Appetite stimulants for people with cystic fibrosis

Cited by 3 publications

References 126 publications

Evaluation of the Use of Appetite Stimulants in Pediatric Patients with Cystic Fibrosis

Evaluation of the Use of Appetite Stimulants in Pediatric Patients with Cystic Fibrosis

Parental perceptions of body weight and appetite in infants and toddlers with cystic fibrosis

A novel compounded cyproheptadine hydrochloride oral solution: Accelerated stability study and effects on glucose and lipid metabolism in Wistar rats

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