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Novel therapeutic options for cachexia and sarcopenia
Alessio Molfino1, Maria Ida Amabile1, Filippo Rossi Fanelli1
1a Department of Clinical Medicine , Sapienza University of Rome , Rome , Italy.
Introduction:
Cachexia and sarcopenia are conditions phenotypically characterized by muscle loss and represent a factor of poor prognosis, increasing patients' morbidity and mortality. Cachectic and sarcopenic patients often suffer from low quality of life, presenting lower muscle strength and appetite loss, which makes research on novel treatment strategies to ameliorate clinical response including patient's symptoms, the objective of scientific interest.
Areas Covered:
This article covers recent developments in the area of cachexia and sarcopenia treatment and therapeutic interventions, targeting central nervous system involvement, key inflammatory and muscle-specific metabolic pathways.
Expert Opinion:
A number of promising agents have being evaluated, such as enobosarm, a selected androgen receptor modulator, and anamorelin, a ghrelin agonist which have been recently studied in phase III trials. These and other agents (i.e., infliximab, tocilizumab, MABp1, bimagrumab) have shown significant impact on reversal of skeletal muscle loss, but limited effect on physical function. In the last few years advancement in the number and type of potential treatments for cachexia and sarcopenia have been obtained and we have now available more data on measurable effects of several drugs on patients' nutritional and metabolic parameters and outcomes.
Insights
Novel treatments for cachexia and sarcopenia show promise in reversing muscle loss. While agents like enobosarm and anamorelin have advanced, their impact on physical function requires further study for improved patient outcomes.
Area of Science:
- Muscle wasting disorders
- Geriatric medicine
- Pharmacology
Background:
- Cachexia and sarcopenia are characterized by muscle loss, leading to poor prognosis, increased morbidity, and mortality.
- These conditions significantly reduce patients' quality of life, manifesting as decreased muscle strength and appetite loss.
Purpose of the Study:
- To review recent advancements in therapeutic interventions for cachexia and sarcopenia.
- To explore treatments targeting the central nervous system and key metabolic pathways involved in muscle wasting.
Main Methods:
- Review of recent developments in cachexia and sarcopenia treatment strategies.
- Evaluation of promising agents including selective androgen receptor modulators and ghrelin agonists.
- Analysis of clinical trial data for agents like enobosarm and anamorelin.
Main Results:
- Several agents, including enobosarm and anamorelin, have shown efficacy in reversing skeletal muscle loss.
- Agents such as infliximab, tocilizumab, MABp1, and bimagrumab also demonstrated impact on muscle mass.
- A notable limitation is the limited effect of these treatments on improving physical function.
Conclusions:
- Significant progress has been made in developing potential treatments for cachexia and sarcopenia.
- More data are available on the measurable effects of drugs on nutritional and metabolic parameters.
- Further research is needed to enhance the impact of these therapies on physical function in affected patients.
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