Effect of Megestrol Acetate and Testosterone on Body Composition and Hormonal Responses in COPD Cachexia

Casaburi, Richard; Nakata, Junko; Bistrong, Lawrence; Torres, Edwardo; Rambod, Mehdi; Pórszász, János

doi:10.15326/jcopdf.3.1.2015.0128

Cited by 8 publications

(10 citation statements)

References 48 publications

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“…In the past few decades, various studies have demonstrated that androgens could exert anti-inflammatory and protective effects through direct or indirect effects in pulmonary diseases (6)(7)(8). Several randomized controlled trials (RCTs) investigated the influence of exogenous androgen therapy on body composition, muscle strength, exercise capacity and health-related quality of life (HRQoL) in patients with COPD (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Anabolic-androgenic steroids for patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Liu

Huang

et al. 2022

Front. Med.

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BackgroundTestosterone deficiency is common in chronic obstructive pulmonary disease (COPD) patients. There has been a growing interest in the potential use of anabolic-androgenic steroids (AASs) in patients with COPD recently. However, whether AASs could improve their clinical outcomes remains unknown.MethodsIn order to explore the efficacy of AASs in patients with COPD, systematic search of MEDLINE, Embase, the Cochrane Library and ClinicalTrials.gov for randomized controlled trials (RCTs) of AASs for COPD published before March 17, 2022 was performed.ResultsData were extracted from 8 articles involving 520 participants. The median number of participants per study was 39.5 and the mean follow up was 14.2 weeks. As compared to the control group, AASs therapy could significantly improve body weight (weighted mean difference (WMD), 1.38 kg; 95% CI, 0.79 to 1.97 kg), fat-free mass (WMD, 1.56 kg; 95% CI, 0.94 to 2.18 kg) and peak workload (WMD, 6.89W; 95% CI, 3.97 to 9.81W) of COPD patients, but no improvements in spirometry indicators and six-minute walking distances (WMD, 16.88 m; 95%, −3.27 to 37.04 m). Based on the available research data, it is uncertain whether AASs treatment could improve the quality of life of COPD patients.ConclusionsLimited published evidence indicates that AASs therapy provides clinical benefits in patients with COPD. However, longer and larger studies are needed to better clarify the efficacy of AASs and draw final conclusions.

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Section: Introductionmentioning

confidence: 99%

Anabolic-androgenic steroids for patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Liu

Huang

et al. 2022

Front. Med.

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“…Cachexia is a multifactorial metabolic syndrome characterised by the dramatic loss of skeletal muscle mass, which is often accompanied by fat loss [ 1 ]. It is a devastating consequence seen in patients with acquired immune deficiency syndrome [ 2 ], burns [ 3 ], cancers [ 4 , 5 ], chronic obstructive pulmonary disease [ 6 ], chronic heart [ 7 ] and renal failures [ 8 ], diabetes [ 9 ], and sepsis [ 10 , 11 , 12 ]. During these disorders, the basal energy expenditure increases, which enhances the fat and protein catabolism primarily from the energy reserve organs and thus leads to wasting [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Repurposing of Antibiotic Sulfisoxazole Inhibits Lipolysis in Pre-Clinical Model of Cancer-Associated Cachexia

Chitti

Marzan

Shahi

et al. 2021

Biology

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Clinical management of cancer-associated cachexia, a multi-organ wasting syndrome, has been challenging without effective treatment strategies. An effective treatment that directly targets cancer-induced wasting is desperately needed to improve the quality of life and the survival of cancer patients. Recently, an antibiotic SFX was shown to have anti-tumour and anti-metastatic effects in mouse models of breast cancer. Hence, in this study, we examined the efficacy of SFX in the treatment of cancer-induced cachexia. C26 cachexic mice models were administered with SFX, and the tumour volume and body weight were regularly measured. Blood glucose, skeletal muscles, and adipose tissue were examined at the endpoint. Contrary to a previous study, SFX did not reduce the tumour volume in mice bearing C26 cells. Administration of SFX neither revealed any survival benefit nor rescued C26 cachectic mice from muscle wasting. Interestingly, SFX administration partially rescued (~10%) tumour-induced weight loss by preserving both the subcutaneous and intestinal fat mass. Together, these results suggest that the administration of SFX could partially rescue cancer-induced weight loss by inhibiting lipolysis. As anti-cachexia therapies are scarce, the results could facilitate the design of combinatorial therapies involving SFX, standard-of-care chemotherapeutics, and drugs that inhibit muscle atrophy for the treatment of cancer cachexia.

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“…Studies that have included nutritional support and exercise without the addition of anabolic steroids (28,29,31) have found improvements in body weight, muscle strength, exercise performance and quality of life but no changes in FFM. Whereas the provision of megestrol acetate and testosterone alone in COPD patients with cachexia has been found to be associated with significant weight gain including both FM and FFM (50).…”

Section: Body Composition Improvements In Copdmentioning

confidence: 96%

Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update

Collins¹,

Yang²,

Chang³

et al. 2019

J. Thorac. Dis.

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Chronic obstructive pulmonary disease (COPD) primarily affects the lungs but due to the accompanying chronic systematic inflammation and the symptoms associated with the disease there are many extrapulmonary effects which include complex physical and metabolic adaptations. These changes have been associated with reduced exercise capacity, increased nutritional requirements, altered metabolic processes and compromised nutritional intake. As a result, nutritional depletion in COPD is multi-faceted and can involve imbalances of energy (weight loss), protein (sarcopenia), and periods of markedly increased inflammation (pulmonary cachexia) which can increase nutritional losses. As a result, depletion of both fatmass (FM) and fat-free mass (FFM) can occur. There is good evidence that nutritional support, in the form of oral nutritional supplements (ONS), can overcome energy and protein imbalances resulting in improved nutritional status and functional capacity. However, in order to treat the aetiology of sarcopenia, frailty and cachexia, it is likely that targeted multi-modal interventions are required to address energy and protein imbalance, specific nutrient deficiencies, reduced androgens and targeted exercise training. Furthermore, interventions taking a disease-course approach, are likely to hold the key to effectively managing the common and costly problem of nutritional depletion in COPD.

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Effect of Megestrol Acetate and Testosterone on Body Composition and Hormonal Responses in COPD Cachexia

Cited by 8 publications

References 48 publications

Anabolic-androgenic steroids for patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Anabolic-androgenic steroids for patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis

Repurposing of Antibiotic Sulfisoxazole Inhibits Lipolysis in Pre-Clinical Model of Cancer-Associated Cachexia

Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update

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