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Published on: June 6, 2020
Clinical Inquiry: Is megestrol acetate safe and effective for malnourished nursing home residents?
Frances K Wen1, James Millar1, Linda Oberst-Walsh2
1University of Oklahoma School of Community Medicine, Tulsa, OK, USA.
Abstract:
No. Megestrol acetate (MA) is neither safe nor effective for stimulating appetite in malnourished nursing home residents. It increases the risk of deep vein thrombosis (strength of recommendation [SOR]: C, 2 retrospective chart reviews), but isn't associated with other new or worsening events or disorders (SOR: B, single randomized controlled trial [RCT]). Over a 25-week period, MA wasn't associated with increased mortality (SOR: B, single RCT). After 44 months, however, MA-treated patients showed decreased median survival (SOR: B, single case-control study). Consistent, meaningful weight gain was not observed with MA treatment (SOR: B, single case-control study, single RCT, 2 retrospective chart reviews, single prospective case-series).
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