Relationship of Initial Pancreatic Enzyme Replacement Therapy Dose With Weight Gain in Infants With Cystic Fibrosis.
J Pediatr Gastroenterol Nutr
; 67(4): 520-526, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-30052568
ABSTRACT
OBJECTIVE:
The aim of the study is to test the hypothesis of a positive relationship between initial dose of pancreatic enzyme replacement therapy (PERT) in infants with cystic fibrosis (CF) and optimal weight gain over the first 2 years of life.METHODS:
Using the CF Foundation Patient Registry, we identified 502 children born in 2010 and used multivariable models to compare as our primary analysis their 2-year changes in weight-for-age z score (WAZ) and as our secondary analysis weight-for-length percentile (W/L%) by initial PERT dose. We focused on initial dose without reference to subsequent changes in treatment to avoid confounding by indication (severity).RESULTS:
Initial PERT dose demonstrated a linear relationship to change in WAZ and W/L% at age 2 years. An initial dose of >1500 lipase units/kg/largest meal resulted in a higher likelihood of attaining WAZ at 2 years at or above the birth WAZ (adjusted odds ratio [aOR] 1.87, 95% confidence interval [CI] 1.22-2.86) and at the top quartile for improvement over 2 years in WAZ (aOR 1.90, 95% CI 1.19-3.05). There was no correlation between initial PERT dose and weight at initial PERT encounter (Pâ=â0.35). Findings were similar for W/L% and when the cohort was restricted to infants who began PERT in the first 3 months of life.CONCLUSIONS:
Infants receiving higher initial PERT dose demonstrate better weight-related outcomes, as reflected by attainment of favorable changes in WAZ and W/L%, at age 2 years.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aumento de Peso
/
Fibrose Cística
/
Terapia de Reposição de Enzimas
Tipo de estudo:
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Vaticano