Long‐term trial of cyproheptadine as an appetite stimulant in cystic fibrosis

@article{Homnick2005LongtermTO,
  title={Long‐term trial of cyproheptadine as an appetite stimulant in cystic fibrosis},
  author={Douglas N. Homnick and John H Marks and Karyl L. Hare and Sally Bonnema},
  journal={Pediatric Pulmonology},
  year={2005},
  volume={40}
}
Appetite stimulants have been used to help overcome decreased appetite and malnutrition in children and adults with various chronic illnesses, including cystic fibrosis (CF). Stimulants have included megestrol acetate (MA), cyproheptadine hydrochloride (CH), cannabinoids, hydrazine sulfate, anabolic hormones, and growth hormone. Many of these, including MA, have substantial side effects and may not be suitable for prolonged use. We previously studied the effects of CH on weight gain in a short… 
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TLDR
The review shows MA may have a role in the management of anorexia associated with CF and it is not possible to be conclusive for the other agents given the low numbers in the studies.
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TLDR
Cyproheptadine treatment was well tolerated and resulted in significant weight gain in malnourished children, without increasing the body fat percentage.
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TLDR
This study demonstrates that CH is a safe and effective way to promote weight gain in children with cancer/treatment-related cachexia.
Evaluation of Cyproheptadine Hydrochloride Effects on Weight Gain in Underweight Children with Anorexia; A Randomized Clinical Trial
TLDR
Considering the acceptable safety of Cyproheptadine hydrochloride for inducing growth in underweight children, its administration with the aforementioned dose is proposed.
A randomized, double-blind, placebo-controlled trial of cyproheptadine for appetite stimulation in cystic fibrosis.
TLDR
Use of cyproheptadine in cystic fibrosis patients was well tolerated, showing a significant weight gain and a significant increase in BMI after 12 weeks, and a clinically relevant effect size for weight/age (z score) and body mass index for age (Z score) was found.
Appetite stimulants for people with cystic fibrosis.
TLDR
In the short term (six months) in adults and children, appetite stimulants improved only two of the outcomes in this review - weight (or weight z score) and appetite; and side effects were insufficiently reported to determine the full extent of their impact.
Short-Term Cyproheptadine Therapy in Underweight Children: Effects on Growth and Serum Insulin-like Growth Factor-I
TLDR
Cyproheptadine therapy in underweight children increased caloric intake and serum IGF-I concentration and consequently enhanced growth velocity and weight and height velocities were significantly greater in the intervention group than those of the placebo group.
State of the Art Appetite Stimulants Use in Cystic Fibrosis
TLDR
The use of several appetite stimulants used in CF andother diseases to improve appetite and maximize caloric intake is summarized.
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TLDR
In conclusion, cyproheptadine hydrochloride appears to be an effective appetite stimulant with minimal side effects in children and adults with CF.
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TLDR
A study was undertaken in a group of chronically hospitalized asthmatic children at the Asthmatic Unit of St. Luke's Convalescent Hospital for the possible effect of drug induced hypoglycemia as the cause of hyperphagia and thus weight gain, and the effect of this agent on carbohydrate tolerance.
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TLDR
Weight, body fat, and lean body mass increased and pulmonary function improved in the children with CF given megestrol acetate, and serum cortisol levels decreased in the MA group.
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TLDR
Two appetite stimulants, megestrol acetate and cyproheptadine were administered in a randomized trial to 14 patients who had no evidence of opportunistic infection or malabsorption but were wasted as a result of human immunodeficiency virus (HIV) infection.
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TLDR
Short-term use of megestrol acetate results in significant weight gain and improved pulmonary function in malnourished subjects with CF, and provides the foundation for multiyear, longitudinal trials in a larger number of patients with CF.
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TLDR
A randomized, placebo‐controlled, double‐blinded clinical trial using cyproheptadine, 8 mg orally three times a day in 295 patients with advanced malignant disease found that it did not significantly abate progressive weight loss.
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TLDR
Four patients with severe cystic fibrosis lung disease, anorexia and weight loss, received Megestrol Acetate, as an appetite stimulant, with significant weight gain in all patients and an increase in their weight for age percentile after 6 months of use.
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TLDR
Patients receiving cyproheptadine showed a marked increase in appetite, an associated weight gain, and an accelerated linear growth rate, which could not be ascribed to a superior antihistaminic or antiasthmatic activity of the compound.
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TLDR
Increase in appetite and weight was significantly greater statistically in those who received cyproheptadine, compared with placebo for effectiveness in producing appetite stimulation and weight gain in healthy, underweight, adults.
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TLDR
It is concluded that MA safely increased appetite and body weight, stimulated ventilation, and improved body image in underweight COPD patients, but did not improve respiratory muscle function or exercise tolerance.
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