Cyproheptadine enhances weight gain in children with FTT, modulating Nesfatin-1 and NUCB2.

The study addresses Failure to Thrive (FTT) in children, particularly those with co-occurring food allergies, a complex condition characterized by inadequate weight gain. Current management often relies on dietary interventions, but pharmacotherapeutic options are limited, especially when dietary restrictions are necessary due to allergies. Cyproheptadine hydrochloride (CH), an antihistamine known for its appetite-stimulating properties, presents a potential therapeutic avenue. This research explores CH's impact on growth parameters and the modulation of appetite-regulating peptides in this vulnerable pediatric population.

This non-randomized, real-world study enrolled children aged 1-3 years diagnosed with FTT and food allergy. Participants were allocated to either a treatment group (T-group, n = 25) or a control group (NT-group, n = 19). The T-group received cyproheptadine at 0.15 mg/kg twice daily for 12 weeks. Primary outcomes included anthropometric indices such as body weight, WAZ (weight-for-age Z-score), WLZ (weight-for-length Z-score), BMI (body mass index), height, and LAZ (length-for-age Z-score). Secondary outcomes assessed clinical symptom scores and serum levels of the appetite-regulating peptides Nesfatin-1 and NUCB2.

After 12 weeks of treatment, the T-group demonstrated significantly greater improvements in body weight (10.32 ± 0.28 kg vs. 9.05 ± 0.23 kg, P = 0.002), WAZ (P < 0.001), WLZ (P < 0.001), and BMI (P = 0.001) when compared to the NT-group. No significant differences were observed in height or LAZ between the groups. Within the T-group, all weight-based indices (body weight, WAZ, WLZ, BMI) showed significant improvements from baseline to week 12 (P < 0.001 for all). > Cyproheptadine treatment was also associated with significant reductions in serum Nesfatin-1 (P = 0.000) and NUCB2 (P = 0.043) levels. At baseline, reduced food intake and sleep disturbances were negatively correlated with WAZ and LAZ, respectively.