Gupta Shivani R, Lu Peter L, Vaz Karla H, Yacob Desale, Wall Jody, Van Diest Ashley M Kroon, Di Lorenzo Carlo, Bali Neetu
Department of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Department of Pediatric Psychology and Neuropsychology, Nationwide Children's Hospital, Columbus, OH, USA.
Paediatr Drugs. 2023 May;25(3):359-363. doi: 10.1007/s40272-023-00567-w. Epub 2023 Mar 21.
Baclofen can decrease rumination frequency in adults with rumination syndrome. Outcomes of baclofen treatment in children with rumination syndrome have not been described. The aim of this study was to examine the safety and efficacy of baclofen in children with rumination syndrome in combination with behavioral therapy at a single center.
We performed a retrospective review of children aged 0-18 years with rumination syndrome based on Rome criteria and prescribed baclofen by a pediatric gastroenterologist at the Nationwide Children's Hospital, Columbus, Ohio, USA, between 2012 and 2019. Children without follow-up data or who were prescribed baclofen for other symptoms were excluded.
We identified 44 children with rumination syndrome who were prescribed baclofen by a pediatric gastroenterologist. Seventeen either did not have follow-up data or never started the medication. We included 27 patients in the study: 22 (81.5%) female, median age 14.5 years (range 10-18 years) and 100% Caucasian. Twenty patients (74%) received baclofen 5 mg and seven patients (26%) received baclofen 10 mg three times daily. Most patients received behavioral therapy and baclofen simultaneously. Thirteen patients (48%) reported improvement in symptoms, primarily a decrease in rumination frequency, at their first follow-up visit. Regurgitation frequency per week decreased after starting baclofen (p < 0.05). One patient experienced dizziness. No other side effects were reported.
Nearly half of our patients with rumination syndrome improved after baclofen. It was well tolerated with minimal side effects. This suggests that baclofen in addition to behavioral therapy can improve symptoms of rumination syndrome. Prospective, controlled studies in a larger cohort of children with rumination syndrome are needed to confirm these findings.
巴氯芬可降低反刍综合征成人患者的反刍频率。巴氯芬治疗反刍综合征儿童的疗效尚未见报道。本研究的目的是在单一中心探讨巴氯芬联合行为疗法治疗反刍综合征儿童的安全性和有效性。
我们对2012年至2019年期间在美国俄亥俄州哥伦布市全国儿童医院就诊、符合罗马标准且由儿科胃肠病学家开具巴氯芬处方的0至18岁反刍综合征儿童进行了回顾性研究。排除无随访数据或因其他症状开具巴氯芬处方的儿童。
我们确定了44例由儿科胃肠病学家开具巴氯芬处方的反刍综合征儿童。其中17例没有随访数据或从未开始用药。我们将27例患者纳入研究：22例（81.5%）为女性，中位年龄14.5岁（范围10至18岁），均为白种人。20例患者（74%）每日三次服用5毫克巴氯芬，7例患者（26%）每日三次服用10毫克巴氯芬。大多数患者同时接受行为疗法和巴氯芬治疗。13例患者（48%）在首次随访时报告症状改善，主要是反刍频率降低。开始服用巴氯芬后每周反流频率降低（p<0.05）。1例患者出现头晕。未报告其他副作用。
近一半的反刍综合征患者服用巴氯芬后症状改善。其耐受性良好，副作用最小。这表明巴氯芬联合行为疗法可改善反刍综合征症状。需要在更大规模的反刍综合征儿童队列中进行前瞻性对照研究以证实这些发现。
