(214) Combination vitamin therapy is non-inferior to individual supplementation therapy in children with cystic fibrosis

Background: Pancreatic insufficient children with cystic fibrosis (CF) are routinely supplemented with fat-soluble vitamins A, D, E, and K, as per national guidelines, and the serum vitamin levels are checked in annual review assessments. Traditionally, the formulations have involved preparations that provide Vitamin E, and K separately, but A and D together. This has proven to be challenging to parents and carers looking after young children with CF. A new formulation (Paravit – CF), containing all the required vitamins in one easily deliverable format, became available in the UK in 2018, but uncertainty remained as to their efficacy in maintaining healthy vitamin levels. This study, temporally explored the efficacy of this approach, comparing data from before and after.

Methods: Royal Manchester Children’s Hospital (RMCH), is a large tertiary CF center in northwest England, and cares for 350 children with CF, through direct input (200 children) and by shared care arrangements (150 children). An electronic registry (THRIVE) captures anonymized pre- and post-supplementation data, including vitamins levels, anthropometric parameters, and patient-reported outcome measures, for children under direct care at RMCH. This study explores temporally serum vitamin levels and growth parameters (weight, height and BMI) before and after Paravit – CF supplementation.

Results:

Results: In this preliminary analysis, complete data was available on only 45 children. No significant change was observed in the vitamin levels (A, D, and E) before and after Paravit - CF formulation was introduced. Furthermore, anthropometric parameters remained stable.

Conclusions:

Conclusion: A new vitamin supplementation program using a single formulation did not result in a loss of efficacy in attaining desirable vitamin levels and in maintaining anthropometric parameters. Subsequent research should explore parental satisfaction using this approach using patient-reported outcome measures.

Acknowledgements: This work was part supported but not influenced by an unrestricted grant from Parapharm Development Ltd, United Kingdom

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