Whey-Based, Medium-Chain Triglyceride–Enhanced Ketogenic Formula in Pediatric Refractory Epilepsy

A ready-to-feed (RTF), whey-based, medium-chain triglyceride–enhanced (WBME) ketogenic formula was safe and effective in young patients with refractory epilepsy, according to a recent study. The results were published in Seizure – European Journal of Epilepsy.

“Ketogenic metabolic therapy (KMT) has demonstrated effectiveness in seizure reduction. However, patient compliance and adverse effects limit its use,” the study authors wrote.

They retrospectively reviewed patients who were given KMT between Jan. 1, 2015, and Feb. 28, 2018, who received at least 75% of their total calories from the WBME formula, and who were monitored for three months. Outcomes included gastrointestinal issues, acidosis, serum blood glucose and beta-hydroxybutyrate levels, unintentional weight changes, diet response (≥50% reduction in seizures), seizure freedom, and change in formula or discontinuation of therapy.

Final analysis included 26 patients, 13 of who were males; the mean age was 6.1 years. Thirteen patients each were established patients who received a standard ketogenic formula before changing to the WBME formula, and patients new to KMT whose therapy was initiated using the WBME formula. None of the patients in either study group discontinued therapy or needed their formula changed. Overall, the diet response rate was 96%, and the rate of seizure freedom at three months posttreatment was 20%. Among the most common adverse events was constipation (69%).

“Our study supports the conclusion that the WBME ketogenic formula is effective and well tolerated in pediatric patients with refractory epilepsy. Additionally, our results support previously published data that patients who are fed predominately ketogenic formulas are more likely to be diet responsive and have lower dropout rates,” the researchers wrote in their conclusion.