Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang: Kesulitan makan pada anak merupakan masalah klinis yang umum dan dapat menyebabkan weight faltering serta gangguan pertumbuhan. Intervensi nonfarmakologis seperti edukasi feeding rules atau penggunaan selang nasogastrik tidak selalu efektif atau dapat diterima oleh anak dan keluarganya. Oleh karena itu, diperlukan alternatif intervensi farmakologis yang aman dan efektif untuk meningkatkan nafsu makan dan status gizi anak. Tujuan: Menilai efektivitas cyproheptadine hydrochloride dalam meningkatkan nafsu makan dan status antropometri pada anak usia 12–60 bulan dengan weight faltering atau gizi kurang tanpa komplikasi. Metode: Uji klinis acak tersamar ganda ini melibatkan anak usia 12–60 bulan yang dibagi menjadi kelompok intervensi (cyproheptadine 0,25 mg/kg/hari selama 4 minggu) dan kelompok kontrol (plasebo). Evaluasi dilakukan pada minggu ke-0, ke-4 (akhir intervensi), dan ke-8 (4 minggu setelah intervensi dihentikan), mencakup skor Early Childhood Appetite and Satiety Tool (ECAST), berat badan, tinggi badan, indeks massa tubuh (IMT), skor WHZ, serta kecukupan energi dan zat gizi. Hasil: Cyproheptadine hydrochloride secara signifikan meningkatkan skor total ECAST dari median 26,5 menjadi 31 pada minggu ke-4 (p < 0,0001) dan menjadi 36 pada minggu ke-8 (p = 0,005), menunjukkan efek residual pascaintervensi. Peningkatan skor nafsu makan tampak pada seluruh domain ECAST, paling menonjol pada kelompok intervensi. Berat badan, tinggi badan dan IMT meningkat lebih besar pada kelompok intervensi dibanding kontrol (p<0,0001; p=0,008 dan p<0,0001). Peningkatan skor WHZ juga lebih tinggi secara bermakna pada kelompok intervensi dibandingkan kontrol, baik pada periode awal (minggu 0–≤4; 0,49 vs 0,155; p < 0,0001), periode 4–≤8 minggu (rerata 0,22 vs 0,05; p = 0,038), maupun kumulatif hingga >8 minggu (0,63 vs 0,175; p < 0,0001). Hal ini menunjukkan bahwa efek intervensi tetap berlanjut meskipun pemberian obat telah dihentikan. Kesimpulan: Pemberian cyproheptadine hydrochloride selama empat minggu terbukti efektif dalam meningkatkan nafsu makan, berat badan, tinggi badan, IMT, dan skor WHZ pada anak dengan weight faltering atau gizi kurang, dengan efek yang bertahan hingga minggu ke-8. Efektivitas selaras dengan perbaikan status antropometri.

---

Background: Feeding difficulties are common clinical problems in young children and may lead to weight faltering and impaired growth. Non-pharmacological approaches such as feeding rules education or nasogastric tube insertion are not always effective or well accepted by children and their families. Therefore, safe and effective pharmacological alternatives are needed to improve appetite and nutritional status in children.

Objective: To evaluate the effectiveness of cyproheptadine hydrochloride in improving appetite and anthropometric status in children aged 12–60 months with uncomplicated weight faltering or mild undernutrition without complications.

Methods: This double-blind randomized controlled trial included children aged 12–60 months who were allocated into an intervention group (cyproheptadine 0.25 mg/kg/day for 4 weeks) and a control group (placebo). Assessments were conducted at baseline, week 4 (end of intervention), and week 8 (four weeks post-intervention), including the Early Childhood Appetite and Satiety Tool (ECAST) score, body weight, body height, body mass index (BMI), WHZ, and intake adequacy of energy and nutrients.

Results: Cyproheptadine hydrochloride significantly increased the total ECAST score from a median of 26.5 at baseline to 31 at week 4 (p < 0.0001) and to 36 at week 8 (p = 0.005), indicating a sustained post-intervention effect. Appetite improvement was observed across all ECAST domains and was most prominent in the intervention group. Weight, height and BMI increased significantly more in the intervention group compared to controls (p<0.0001; p=0,008 and p<0,0001, respectively). WHZ scores also improved significantly in the intervention group: from week 0 to ≤4 (median increase 0.49 vs 0.155; p<0.0001), from week 4 to ≤8 (mean increase 0.22 vs 0.05; p = 0.038), and cumulatively to >8 weeks (median increase 0.63 vs 0.175; p<0.0001). These findings suggest a continued benefit beyond the intervention period.

Conclusion: A four-week administration of cyproheptadine hydrochloride effectively enhances appetite, weight gain, height gain, BMI, and WHZ in children with weight faltering or mild undernutrition without complications, with sustained benefits up to eight weeks. These improvements are supported by enhanced anthropometric outcomes."

"The volume ?Appetite control? provides a comprehensive description of the mechanisms controlling food intake, and thereby energy balance, in the mammalian organism. During the last decade, research in this area has produced a remarkable wealth of information and has characterized the function of numerous peptides, transmitters, and receptors in appetite control. Dysfunction of these circuits leads to obesity, a growing health concern. However, the plethora of mechanistic information is in marked contrasts to an almost complete lack of anti-obesity drugs that meet the safety standards required for the chronic therapy of morbid obesity. Consequently, ongoing research aims to identify additional targets and agents for a pharmacological intervention. Thus, the mechanisms of appetite control as well as all agents interfering with its control are of considerable practical interest."