Appetite stimulants in cystic fibrosis: a systematic review

Abstract

The review shows MA may have a role in the management of anorexia associated with CF. It is not possible to be conclusive for the other agents given the low numbers in the studies. Larger randomized, controlled trials of MA are necessary to confirm its safety and validate efficacy in CF.

Benefits associated with escalated begging behaviour of black-billed magpie nestlings overcompensate the associated energetic costs

“…Its action as appetite stimulant appears not to be due to a hypoglycaemic-induced hyperphagia or an increase in endogenous growth hormones (Bergen, 1964;Stiel et al, 1970). Cyproheptadine is broadly used in human patients, including children, that suffer from diseases such as cancer, HIV, cystic fibrosis and eating disorders (see Chinuck et al, 2007;Couluris et al, 2008;Mahachoklertwattana et al, 2009), where an increase in body mass is desirable. Cyproheptadine is also used as an antihistaminic because it blocks H 1 histamine receptors (Stone et al, 1961) and, similar to other antihistaminic substances, cyproheptadine has minimal side effects, consisting mainly of transient drowsiness [see Homnick et al (Homnick et al, 2004) and references therein].…”

“…This pharmaceutical is a type 2 serotonin receptor antagonist, which directly acts on the hunger centre at the hypothalamus (Stone et al, 1961;Chakrabarty et al, 1967). Cyproheptadine is broadly used in humans, including children, as a safe and effective appetite stimulant (Chinuck et al, 2007;Couluris et al, 2008;Mahachoklertwattana et al, 2009). It is also often used in other animals, mainly in cats (see e.g.…”

A Disease-Relevant High-Content Screening Assay to Identify Anti-Inflammatory Compounds for Use in Cystic Fibrosis

“…25,26 In addition, one of the progesterone derivatives that the screen identified as an inhibitor, megestrol acetate, has been shown to promote weight gain in CF patients. 27 Because CF patients have a high catabolic output due to fighting their ongoing pathogen-induced inflammatory response, NFκB inhibition may eventually contribute to weight gain by promoting a compensatory mechanism upon resolution of inflammation. The identification of megestrol acetate and fluticasone propionate as NFκB inhibitors in these cells also helped with further validation of this assay as these compounds have been tested in CF patients for management of clinical symptoms.…”

3.19 Nutrition in Cystic Fibrosis

“…Larger trials with appropriate patient selection are needed in order to establish its safety and effectiveness. Appetite stimulants (AS) are often requested by individuals with CF, or by parents of a child with CF, in anticipation of an enhanced appetite and increased energy intake to promote weight gain [21] . While megestrol acetate is one of the most studied AS in CF, results are not conclusive on the use of AS in patients with CF at this time, and larger, controlled studies are needed.…”