Effect of Cyproheptadine on Weight and Growth Velocity in Children with Silver-Russell Syndrome.

Objectives: Nutritional management of children with Silver-Russell syndrome (SRS) is crucial, especially before initiating growth hormone therapy (GHT). Since cyproheptadine (CYP) has been reported to be orexigenic, we retrospectively investigated the effects of CYP on changes in weight and height in SRS patients. Methods: Anthropometric parameters (weight [W], length or height [H], relative body weight for height [W/H] and body mass index [BMI]) were recorded for 34 children with SRS receiving CYP. We specifically analyzed the anthropometric parameters (expressed in median) in a group of 23 patients treated with CYP at baseline (M0-CYP) and every 3 months (M3 to M12-CYP) after the initiation of CYP treatment. Results: The 23 SRS children treated by CYP only had weight stagnation during the months preceding the start of treatment. Anthropometric parameters, especially the weight, differed significantly between M0-CYP and all other times (M3, M6, M9, M12-CYP). After one year of treatment, a gain in overall length/height and weight was observed (W: +1.1 SDS; H: +0.5 SDS). At M3, significant improvements in W/H (74.9% vs. 79.3% (p = 0.01)) and BMI (-3.4 vs. -2.4 SDS (p = 0.001)) were also observed. Twenty-one patients (91%) improved their weight by at least +0.5 SDS, and 12 (52%) by at least +1 SDS. Conclusions: Our results show that CYP can be effective in SRS patients with significant improvements in growth velocity and nutritional status before initiation of GHT. Further prospective studies are required to confirm these results. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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