(200) Efficacy of cyproheptadine for appetite stimulation in pediatric cystic fibrosis patients

Thursday, November 3, 2022

12:00 PM – 12:40 PM ET

Presenting Author(s)

Tara L. Blesh-Boren, PharmD

Clinical Pharmacy Specialist
Nebraska Regional Pediatric CF Center
Omaha, Nebraska, United States

Co-Author(s)

KR

Kendall Roessler, PharmD

United States
EZ

Elizabeth Zdyb, PharmD

Omaha, Nebraska, United States

Background: Cystic fibrosis (CF) is an autosomal recessive disease that results in progressive lung disease and may lead to poor nutritional status secondary to pancreatic insufficiency (PI). Due to impaired digestion and malabsorption, weight loss and malnutrition are complications of CF, and have been linked to declining lung function and increased infection. This study aims to evaluate the impact of cyproheptadine on nutritional status and lung health in pediatric patients with CF and PI.

Methods: A retrospective chart review was conducted on patients between 1-21 years of age with CF and PI initiated on cyproheptadine for appetite stimulation between 2013 and 2019. Fifty-two patients with poor nutritional status were analyzed, comparing changes in body mass index (BMI) z-scores or weight-for-length based upon age, lung function (FEV1) and pulmonary exacerbations for 1 year prior to and 1 year after starting cyproheptadine, or until discontinuation.

Results: Patients initiated on cyproheptadine realized an improvement in BMI and weight-for-length z-scores of +0.363 and +0.96 respectively after 12 months (p=0.002, 0.0002). Reduction in the number of exacerbations was demonstrated, with an improvement of 1.41 fewer exacerbations per calendar year (p< 0.001) at 12 months post cyproheptadine initiation. There were no significant changes in FEV1.

Conclusions: The results of this study indicate a clinical benefit with cyproheptadine for appetite stimulation based on patients’ use for at least 12 months. Cyproheptadine was found to be an appropriate therapy to improve nutritional status as demonstrated by significant increase in BMI and weight-for-length z-scores and was correlated with a reduction in the number of exacerbations. These findings suggest that cyproheptadine is an effective treatment addition for providing alternative nutritional support in patients with CF and PI down to 1 year of age.

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