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Appetite stimulants in cystic fibrosis: a systematic review
Author(s) -
Chinuck R. S.,
Fortnum H.,
Baldwin D. R.
Publication year - 2007
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/j.1365-277x.2007.00824.x
Subject(s) - medicine , appetite , anorexia , adverse effect , randomized controlled trial , cochrane library , medline , cyproheptadine , cystic fibrosis , meta analysis , intensive care medicine , serotonin , receptor , political science , law
Background The use of appetite stimulants in cystic fibrosis (CF) is controversial because of doubts concerning efficacy and side‐effects. The aim of the review was to establish whether appetite stimulants should be recommended in CF. Materials and methods Medline, AMED, British Nursing Index, Cinahl, Embase, The Cochrane Library, National Research Register and Google were searched. Unpublished studies, case reports and conference abstracts were sought from experts, including authors of identified published articles, and suppliers of appetite stimulants. Results Fifty‐four articles were located. Fifteen studies were suitable for inclusion in the review: 10 studied, megesterol acetate (MA); 1, dronabinol; 2, mirtazapine; and 2, cyproheptadine. MA showed a beneficial effect on lung function, weight, appetite, fat free and fat mass. Adverse effects for MA included adrenal suppression, abnormalities of glycaemic control, mood changes and testicular failure. There was no consistency in the dose, frequency and duration of therapy for MA. Conclusions 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.