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Huh, S. Y.1; Pappa, H. M.1

Journal of Pediatric Gastroenterology and Nutrition: June 2004 - Volume 39 - Issue - p S507
ABSTRACTS: Poster Session Abstracts

1 Division of Gastroenterology and Nutrition, Children’s Hospital Boston, Boston, United States

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Introduction: Cyproheptadine has been used as an appetite stimulant to promote weight gain in both children and adults, but its efficacy remains controversial. Our goal was to systematically examine the existing evidence of the efficacy of cyproheptadine as a weight promoter.

Methods: We conducted a computerized literature search and ascertained additional studies from reference lists and trial authors. Our inclusion criteria were: 1) human subjects; 2) randomized allocation of subjects to study arms; 2) placebo-controlled, parallel group or crossover design; 4) primary or secondary outcome of weight gain. Using a data abstraction form, two independent reviewers extracted the data and determined eligibility for analyses. For each study arm, we calculated the change in mean weight as a percentage of the arm’s mean baseline weight. To permit comparisons of weight gain between trials of varying duration, we defined our summary statistic as net percentage change in weight(treatment minus control) divided by the trial duration in months.

Results: 37 studies of cyproheptadine with a primary or secondary outcome of weight gain were identified for article retrieval. 9 studies with a total of 336 subjects met inclusion criteria and contained sufficient data to calculate a summary statistic. 2 trials were in children (age 4–13 years), 3 trials were in adults (19–58 years) and 4 trials were mixed. Trial length was 4 to 16 weeks, and percent of follow-up ranged from 56–100%. Using a random effects model, the pooled estimate of net percentage change in mean weight per month was +1.8% (95%CI +1.0%, +2.6%, p<0.001). Subanalysis of the 5 studies in subjects with no organic etiology led to a slightly increased effect estimate of +2.0% (95%CI +1.2%, +2.9%).

Conclusion: Cyproheptadine may induce a modest, but clinically meaningful degree of short-term weight gain in subjects with underweight or loss of appetite. Limited existing data suggest that cyproheptadine deserves further study as a weight-promoting agent.

© 2004 Lippincott Williams & Wilkins, Inc.