{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:30:36Z","timestamp":1773819036373,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T00:00:00Z","timestamp":1735084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metabolic dysfunction\u2013associated steatotic liver disease (MASLD) is a common disease in children. Lifestyle modification is the primary treatment but difficult to achieve and maintain. Topiramate is a component of an approved weight loss medication (topiramate\u2010phentermine) in children aged 12 years and older but is more commonly used as a single agent, off\u2010label, for pediatric obesity. Our aim is to describe change in anthropometrics and laboratory values while providing topiramate treatment of pediatric MASLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Descriptive cohort study including patients aged &lt;18 years with MASLD and body mass index (BMI) &gt;95th percentile treated with topiramate for weight loss for \u22653 months from January 1, 2010, to December 30, 2023. The primary outcome was change in serum alanine aminotransferase (ALT) levels from baseline to 3\u20136 months. Secondary outcomes were changes in BMI <jats:italic>z<\/jats:italic> score, glycated hemoglobin, and lipid profile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 43 patients prescribed topiramate, 11 were excluded for nonadherence, leaving 32 (56% boys, 72% non\u2010Hispanic) for further analyses. With topiramate, ALT levels improved (76 vs 50\u2009U\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Further, 43% of patients had either ALT normalization or reduction by &gt;50% from baseline. BMI <jats:italic>z<\/jats:italic> score decreased by 0.1 from baseline to 3\u20136 months. There were no improvements in glycated hemoglobin or lipids. Eight patients (25%) reported mild side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Topiramate, as an adjunct to lifestyle intervention, may be considered in the treatment of pediatric MASLD, specifically in the context of failed lifestyle modification and inability to tolerate or qualify for other obesity pharmacotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.2722","type":"journal-article","created":{"date-parts":[[2024,12,25]],"date-time":"2024-12-25T06:15:02Z","timestamp":1735107302000},"page":"308-313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Topiramate treatment of pediatric metabolic dysfunction\u2013associated steatotic liver disease: A descriptive cohort study"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9432-1425","authenticated-orcid":false,"given":"Taisa","family":"Kohut","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology, and Nutrition University of Miami Miller School of Medicine Miami Florida USA"},{"name":"Division of Gastroenterology, Hepatology, and Nutrition The Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Tou","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition The Children's Hospital of Philadelphia Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Carr","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Pediatrics Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavra","family":"Xanthakos","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Catalina","family":"Arce\u2010Clachar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rima","family":"Fawaz","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Pediatrics Yale University School of Medicine New Haven 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