Megestrol acetate in patients with AIDS and cachexia

Area of Science:

• Endocrinology
• Infectious Diseases
• Clinical Nutrition

Background:

• Cachexia is a significant complication in patients with acquired immunodeficiency syndrome (AIDS).
• Wasting syndrome in AIDS negatively impacts body composition, caloric intake, and overall well-being.
• Effective interventions are needed to manage cachexia in AIDS patients.

Purpose of the Study:

• To evaluate the efficacy of a megestrol acetate liquid formulation in managing cachexia in AIDS patients.
• To assess the impact of megestrol acetate on body weight, body composition, caloric intake, and mental outlook.

Main Methods:

• A 12-week, multicenter, randomized, double-blind, placebo-controlled trial.
• 100 patients with AIDS and significant weight loss were randomized to receive either megestrol acetate (800 mg/d) or a placebo.
• Measurements included caloric intake, body weight, body composition (fat mass, lean mass, body water), and sense of well-being.

Main Results:

• Megestrol acetate significantly increased daily caloric intake by 608 calories compared to 134 calories in the placebo group by week 8.
• Patients receiving megestrol acetate gained an average of 3.86 kg in body weight, primarily as fat mass (3.68 kg gain), while the placebo group lost weight.
• No statistically significant differences were observed in body water, lean mass, or patient survival between the groups. Patients on megestrol acetate reported an improved sense of well-being.

Conclusions:

• The liquid formulation of megestrol acetate is well-tolerated in cachectic AIDS patients.
• Megestrol acetate effectively increases food intake and promotes body weight gain, mainly through increased fat mass.
• The treatment also leads to an improved sense of well-being in this patient population.