MEGACE FOR AIDS CACHEXIA: FOOD FOR THOUGHT

Jeffrey Novak, Jamie S. Barkin

Research output: Contribution to journalArticle

Abstract

Cachexia and weight loss in chronic disease can have profound physiological, psychological, and immunological effects. In AIDS, this process, with its attendant weakness, has been implicated in contributing to patients’ overall poor sense of well being and to more rapid progression of the disease (1–4). Megestrol acetate, a chemotherapeutic agent used in metastatic breast cancer, has been shown to stimulate weight gain and appetite in patients with breast cancer as well as several other metastatic diseases (6–11). Van Roenn et al. (12) conducted a randomized, double‐blind, placebo‐controlled study comparing the effects of megestrol acetate with placebo in patients with AIDS. Two hundred and seventy patients were randomly assigned to one of four treatment arms: 100 mg megace q.i.d., 400 mg q.i.d., 800 mg q.i.d., or placebo. Six parameters were measured after a 12‐wk study period including: 1) net weight gain, 2) time to maximum weight gain, 3) bioelectric impedance analysis of lean body mass, 4) anthropometric analysis, 5) perceived well being analysis, and 6) caloric intake. Of the 270 patients enrolled, 195 were available for final analysis. All treatment groups displayed weight gain from base line at 12 wk; however, this difference attained significance only in the 800 mg/day arm, with a mean weight gain of 1.91 kg. This group also had a statistically greater percentage of patients gaining 2.27 kg of weight when compared with placebo (64.2 vs 21.4%, p < 0.001). No statistical difference was noted, however, for time to maximum weight change in placebo or treatment groups. Lean body mass from base line to last evaluation increased in direct proportion to dose of megestrol acetate but was statistically significant only between the placebo and 800 mg groups (+1.14 kg) (p < 0.001). Anthropometric measures (midarm circumference and triceps skin fold analysis) also increased proportionately to dose of megestrol, whereas total body muscle mass only increased 1 kg in the 800 mg/day test group. In addition, patients communicated an improved sense of well being and increased caloric intake (645.6 calories) on 800 mg/day of megestrol acetate. No adverse effects or increased frequency of opportunistic infections were noted in any patient.

Original languageEnglish (US)
Pages (from-to)1180-1181
Number of pages2
JournalThe American journal of gastroenterology
Volume90
Issue number7
DOIs
StatePublished - Jul 1995

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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