Megestrol acetate for treatment of anorexia-cachexia syndrome

García, Vicente Ruiz; López-Briz, Eduardo; Sanchis, Rafael Carbonell; Perales, J; Bort-Marti, Sylvia

doi:10.1002/14651858.cd004310.pub3

Cited by 194 publications

(167 citation statements)

References 142 publications

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“…Quality of life improvement in patients was seen only when comparing MEGACE vs placebo [91] . The mechanism for the associated weight gain is mostly unknown, although MEGACE may stimulate the synthesis, transport, and release of neuropeptide γ, known to produce appetite-stimulating effects in rats [92] .…”

Section: Megacementioning

confidence: 94%

“…MEGACE has been found to improve appetite, caloric intake and nutritional status in several clinical trials [80][81][82][83][84][85][86][87][88][89][90] . Recently a meta-analysis of 35 trials, comprising 3963 patients, for the effectiveness of MEGACE was conducted [91] , demonstrating a benefit of MEGACE compared with placebo, particularly with regard increase the catabolic response, leading to unsustainable levels of fat and muscle mobilization and levels of muscle depletion that cause significant morbidity and mortality.…”

Section: Megacementioning

confidence: 99%

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Cancer cachexia, mechanism and treatment

Aoyagi¹,

Terracina²,

Ali³

et al. 2015

WJGO

376

282

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It is estimated that half of all patients with cancer eventually develop a syndrome of cachexia, with anorexia and a progressive loss of adipose tissue and skeletal muscle mass. Cancer cachexia is characterized by systemic inflammation, negative protein and energy balance, and an involuntary loss of lean body mass. It is an insidious syndrome that not only has a dramatic impact on patient quality of life, but also is associated with poor responses to chemotherapy and decreased survival. Cachexia is still largely an underestimated and untreated condition, despite the fact that multiple mechanisms are reported to be involved in its development, with a number of cytokines postulated to play a role in the etiology of the persistent catabolic state. Existing therapies for cachexia, including orexigenic appetite stimulants, focus on palliation of symptoms and reduction of the distress of patients and families rather than prolongation of life. Recent therapies for the cachectic syndrome involve a multidisciplinary approach. Combination therapy with diet modification and/or exercise has been added to novel pharmaceutical agents, such as Megestrol acetate, medroxyprogesterone, ghrelin, omega-3-fatty acid among others. These agents are reported to have improved survival rates as well as quality of life. In this review, we will discuss the emerging understanding of the mechanisms of cancer cachexia, the current treatment options including multidisciplinary combination therapies, as well an update on new and ongoing clinical trials.

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Section: Megacementioning

confidence: 94%

Section: Megacementioning

confidence: 99%

Cancer cachexia, mechanism and treatment

Aoyagi¹,

Terracina²,

Ali³

et al. 2015

WJGO

376

282

View full text Add to dashboard Cite

show abstract

“…Various agents, mainly cannabinoids (dronabinol) and megestrol acetate, are used in various patient groups suffering from anorexia e including older patients and longterm residents [127,128].…”

mentioning

confidence: 99%

ESPEN guidelines on nutrition in dementia

et al. 2015

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“…Both oedema and thromboembolic phenomena were commonly reported adverse events. An increased mortality with MA treatment was also identified (RR1.42 CI 1.04-1.94) however it must be noted that the quality of evidence was poor and there was high levels of heterogeneity between the studies, including the patients type, and further prospective studies of MA use and its impact on long term survival are required [19].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous Endoscopic Gastrostomy, Megestrol Acetate and Nasogastric feeding in adult patients with Cystic Fibrosis

Shabbir¹,

Bright-Thomas²,

Zaidi³

et al. 2017

J Gastrointest Dig Syst

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Background/Aims: Malnutrition remains an important and common problem in cystic fibrosis (CF) patients. In adult CF patients, weight loss is associated with poor lung function, and nutritional status has been found to be an independent predictor of mortality. We compared changes in weight and forced expiratory volume in 1 second (FEV 1 ) in patients with CF receiving one of three interventions to encourage weight gain: i) oral megestrol acetate (MA); ii) nasogastric (NG) tube feeding; iii) percutaneous endoscopic gastrostomy (PEG), Our aim was to determine and compare the effectiveness of these interventions in i) stabilising weight and ii) stabilising FEV 1 in CF adults.

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Megestrol acetate for treatment of anorexia-cachexia syndrome

Abstract: This review shows that MA improves appetite and is associated with slight weight gain in cancer, AIDS and in patients with other underlying pathology. Despite the fact that these patients are receiving palliative care they should be informed of the risks involved in taking MA.

Cited by 194 publications

References 142 publications

Cancer cachexia, mechanism and treatment

Cancer cachexia, mechanism and treatment

ESPEN guidelines on nutrition in dementia

Comparison of Percutaneous Endoscopic Gastrostomy, Megestrol Acetate and Nasogastric feeding in adult patients with Cystic Fibrosis

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