Appetite stimulants show positive weight gain in children with cystic fibrosis

Children with cystic fibrosis gained weight within the first 3 months of appetite stimulant therapy, according to a poster presented at the North American Cystic Fibrosis Conference.

“Poor nutrition in people with cystic fibrosis has been associated with poor lung function and greater morbidity and mortality,” Kaitlin Kennedy, PharmD, second year pharmacy resident at Children’s Medical Center Dallas, and colleagues wrote. “Conversely, better nutritional status has been associated with better pulmonary function and fewer cystic fibrosis-associated complications. There is no consensus regarding appetite stimulant therapy.”

In a retrospective study, Kennedy and colleagues assessed 64 children with cystic fibrosis from Jan. 1, 2009, to Dec. 31, 2019, to determine if they experienced changes in weight when given an appetite stimulant, according to the study abstract.

For 6 months in a row, 56 (88%) children received cyproheptadine, six received mirtazapine, one received megestrol and one received dronabinol for appetite stimulation. Researchers assessed patients’ weight at baseline and at 3-, 6- and 12-month follow-up.

Overall, changes in absolute, percentile and z score measurements showed statistically significant increases in weight at 3 months in univariable and multivariable regression analyses.

Specifically, after the first 3 months of appetite stimulant therapy, researchers observed an increase in weight z score in the total cohort (adjusted mean difference for change in weight z score = 0.31; P < .001).

From 3 to 6 months, weight z score continued to increase (0.07), but then plateaued from 6 to 12 months (–0.03).

Additionally, researchers found that cyproheptadine therapy for 3 months was linked to significant improvement in lung function (adjusted mean difference in change in FEV₁ = 3.88; P < .001), according to the abstract.

“These findings suggest that appetite stimulants contribute to weight gain in children with cystic fibrosis, particularly within the first 3 months of therapy,” the researchers wrote.