Use of orexigenic medications in geriatric patients

American Journal Geriatric Pharmacotherapy

Volumn 9, Issue 2, 2011, Pages 97-108

  Thomas, David R ^a  

^a SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

anorexia; cachexia; malnutrition; orexigenic drugs; weight loss

Indexed keywords

AMLODIPINE BESYLATE; APPETITE STIMULANT; CANNABINOID; CIPROFLOXACIN; CONJUGATED ESTROGEN; CORTICOSTEROID; CYPROHEPTADINE; DIGOXIN; ENALAPRIL MALEATE; FAMOTIDINE; FENTANYL; FUROSEMIDE; IPRATROPIUM BROMIDE; LEVOTHYROXINE SODIUM; MIRTAZAPINE; MONOAMINE OXIDASE INHIBITOR; NIFEDIPINE; NIZATIDINE; OMEPRAZOLE; PAROXETINE; PHENYTOIN; POTASSIUM CHLORIDE; PROPACET; PROPACETAMOL; RANITIDINE; RISPERIDONE; SEROTONIN UPTAKE INHIBITOR; SERTRALINE; THALIDOMIDE; TRICYCLIC ANTIDEPRESSANT AGENT; UNCLASSIFIED DRUG; UNINDEXED DRUG; WARFARIN;

AGED; ANOREXIA; APPETITE; ARTHRALGIA; BODY MASS; BODY WEIGHT DISORDER; CARPAL TUNNEL SYNDROME; CLINICAL TRIAL (TOPIC); COGNITIVE DEFECT; DEPRESSION; DIABETES MELLITUS; DIET RESTRICTION; DRUG EFFECT; DRUG ERUPTION; DRUG FEVER; DRUG USE; ENVIRONMENTAL FACTOR; FEEDING BEHAVIOR; FOOD PREFERENCE; FRAIL ELDERLY; GASTRITIS; GERIATRIC PATIENT; HUMAN; HYPERGLYCEMIA; IMMUNE DEFICIENCY; INFLAMMATION; INFLAMMATORY DISEASE; LYMPHOCYTE COUNT; MUSCLE WEAKNESS; MYALGIA; NUTRITION; NUTRITIONAL SUPPORT; PATIENT COUNSELING; PHENOTYPE; PRIORITY JOURNAL; REVIEW; SATIETY; SEDATION; SENSORY NEUROPATHY; SIDE EFFECT; STARVATION; WEIGHT GAIN; WEIGHT REDUCTION;

AGED; ANOREXIA; APPETITE; CACHEXIA; CYTOKINES; DIETARY SUPPLEMENTS; EATING; HUMANS; WEIGHT GAIN;

EID: 79955939762     PISSN: 15435946     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.amjopharm.2011.04.001     Document Type: Review

References (122)

1. Thomas DR. Anorexia: aetiology, epidemiology, and management in the older people. Drugs Aging. 2009;26:557-570.
2. Thomas DR. Unintended weight loss in older persons. Aging Health. 2008;4:191-200. (Pubitemid 351753448)
3. Delaney SJ. Management of anorexia in dogs and cats. Vet Clin North Am Small Anim Pract. 2006;36:1243-1249. (Pubitemid 44645097)
4. Lasheen W, Walsh D. The cancer anorexia-cachexia syndrome: myth or reality? Support Care Cancer. 2010;18:265-272.
5. Lainscak M, Filippatos GS, Gheorghiade M, et al. Cachexia: common, deadly, with an urgent need for precise definition and new therapies. Am J Cardiol. 2008;101:8E-10E.
6. Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for proteinenergy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391-398. (Pubitemid 351186278)
7. Morley JE, Thomas DR. Anorexia and aging: pathophysiology. Nutrition. 1999;15:499-503. (Pubitemid 29279615)
8. McGandy RB, Barrows CH Jr, Spanias A , et al. Nutrient intake and energy expenditure in men of different ages. J Gerontol. 1966;21:581-587.
9. Serra Prat M, Fernandez X, Ribo L, et al. Loss of appetite in elderly people in the community and its relationship with functional capacity [in Spanish]. Med Clin (Barc). 2008;130:531-533. (Pubitemid 351670911)
10. Donini LM, Savina C, Piredda M, et al. Senile anorexia in acute-ward and rehabilitations settings. J Nutr Health Aging. 2008;12:511-517.
11. Evans WJ, Morley JE, Argilés J, et al. Cachexia: a new definition. Clin Nutr. 2008;27:793-799.
12. Chapman KM, Nelson RA. Loss of appetite: managing unwanted weight loss in the older patient. Geriatrics. 1994;49:54-59. (Pubitemid 24081709)
13. Weinsier RL, Hunker EM, Krumdieck CL, Butterworth CE Jr. Hospital malnutrition: a prospective evaluation of general medical patients during the course of hospitalization. Am J Clin Nutr. 1979;32:418-426. (Pubitemid 9129265)
14. Wright BA. Recent weight loss is related to short-term mortality in nursing homes. J Gen Intern Med. 1994;9:648-650.
15. Thomas DR. Loss of skeletal muscle mass in aging: examining the relationship of starvation, sarcopenia and cachexia. Clin Nutr. 2007;26:389-399. (Pubitemid 47091483)
16. Wang SY, Fukagawa N, Hossain M, Ooi WL. Longitudinal weight changes, length of survival, and energy requirements of long-term care residents with dementia. J Am Geriatr Soc. 1997;45:1189-1195. (Pubitemid 27430483)
17. Morley JE, Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc. 1994;42:583-585. (Pubitemid 24180954)
18. Löwe B, Unützer J, Callahan CM, et al. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004;42:1194-1201. (Pubitemid 39627296)
19. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-1983;17:37-49. (Pubitemid 13123113)
20. Fava M. Weight gain and antidepressants. J Clin Psychiatry. 2000;61(Supp 11)S:37-41. (Pubitemid 30616693)
21. Gelenberg AJ, Laukes C, McGahuey C, et al. Mirtazapine substitution in SSRI-induced sexual dysfunction. J Clin Psychiatry. 2000;61:356-360. (Pubitemid 30345937)
22. Carpenter LL, Leon Z, Yasmin S, Price LH. Clinical experience with mirtazapine in the treatment of panic disorder. Ann Clin Psychiatry. 1999;11:81-86. (Pubitemid 29343106)
23. Carpenter LL, Jocic Z, Hall JM, et al. Mirtazapine augmentation in the treatment of refractory depression. J Clin Psychiatry. 1999;60:45-49. (Pubitemid 29069886)
24. Rote NS. Inflammation. In: McCance KL, Huether SE, eds. Pathophysiology: the Biological Basis for Disease in Adults and Children. 3rd ed. St. Louis, Mo: Mosby-Year Book; 1998:205-236.
25. Plata-Salaman CR. Strategies for potential manipulation of anorexia during acute and chronic disease. Nutrition. 1995;11:702-704. (Pubitemid 26006257)
26. Espat NJ, Moldawer LL, Copeland EM 3rd. Cytokine-mediated alterations in host metabolism prevent nutritional repletion in cachectic cancer patients. J Surg Oncol. 1995;58:77-82.
27. Morley JE, Thomas DR. Cachexia: new advances in the management of wasting diseases. J Am Med Dir Assoc. 2008;9:205-210. (Pubitemid 351598063)
28. Pasini E, Aquilani R, Gheorghiade M, Dioguardi FS. Malnutrition, muscle wasting and cachexia in chronic heart failure: the nutritional approach. Ital Heart J. 2003;4:232-235. (Pubitemid 36834097)
29. Ingenbleek Y, Carpentier YA. A prognostic inflammatory and nutritional index scoring critically ill patients. Int J Vitam Nutr Res. 1985;55:91-101.
30. Hyltoft Peterson P, Felding P, Horder M, Tryding N. Effects of posture on concentration of serum proteins in healthy adults. Scand J Clin Lab Invest. 1980;40:623-628.
31. Thomas DR. Distinguishing starvation from cachexia. Clin Geriatr Med. 2002;18:883-891. (Pubitemid 35239189)
32. McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parentr Enteral Nutr. 2009;33:277-316.
33. Fried LP, Tangen CM, Walston J, et al, for Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146-M156.
34. Drey M, Pfeifer K, Sieber CC, Bauer JM. The fried frailty criteria as inclusion criteria for a randomized controlled trial: personal experience and literature review. Gerontology. 2011;57:11-18.
35. Yesavage JA. Geriatric depression scale. Psychopharmacol Bull. 1988;24:709-711.
36. Sheikh J, Yesavage J. Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986;5:165-173. (Pubitemid 17221439)
37. Morley JE, Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc. 1994;42:583-585. (Pubitemid 24180954)
38. Keller HH. Malnutrition in institutionalized elderly: how and why? J Am Geriatr Soc. 1993:41:1212-1218. (Pubitemid 23324871)
39. Blaum CS, Ries BE, Fiatarone MA. Factors associated with low body mass index and weight loss in nursing home residents. J Gerontol A Biol Med Sci. 1995;50:M162-168.
40. De Castro JM. How can eating behavior be regulated in the complex environments of free-living humans? Neurosci Biobehav Rev. 1996;20:119-131. (Pubitemid 126682120)
41. Hotaling DL. Nutritional considerations for the pureed diet texture in dysphagic elderly. Dysphagia. 1992;7:81-85.
42. Johnson RM, Smiciklas-Wright H, Soucy IM, Rizzo JA. Nutrient intake of nursing home residents receiving pureed foods or a regular diet. J Am Geriatr Soc. 1995;43:344-348.
43. Thomas DR, Verdery RB, Gardner L, et al. A prospective study of outcome from protein-energy malnutrition in nursing home residents. JPEN J Parentr Enteral Nutr. 1991;15:400-404.
44. Pick N, McDonald A, Bennett N, et al. Pulmonary aspiration in a long-term care setting: clinical and laboratory observations and an analysis of risk factors. J Am Geriatr Soc. 1996;44:763-768. (Pubitemid 26238717)
45. Thomas DR. Hard to swallow: management of dysphagia in nursing home residents. J Am Med Dir Assoc. 2008;9:455-458.
46. Tariq S, Karcic E, Thomas DR, et al. The use of a noconcentrated-sweets diet in the management of type 2 diabetes in nursing home patients. J Am Diet Assoc. 2001;101:1463-1466. (Pubitemid 33712945)
47. Buckler DA, Kelber ST, Goodwin JS. The use of dietary restrictions in malnourished nursing home patients. J Am Geriatr Soc. 1994;42:1100-1102. (Pubitemid 24309822)
48. Womack P, Breeding C. Position of the American Dietetic Association: liberalized diets for older adults in long-term care. J Am Diet Assoc. 1998;98:201-204. (Pubitemid 28078260)
49. Gants R. Detection and correction of underweight problems in nursing home residents. J Gerontol Nurs. 1997; 23:26-31.
50. Dawe D, Moore-Orr R. Long-intensity range of motion exercise: invaluable nursing care for elderly patients. J Adv Nurs. 1995;21:675-681.
51. Ruuskanen JM, Ruoppila I. Physical activity and physiologic well being among people 65 to 84 years. Age Ageing. 1995;24:292-296.
52. Fiatarone MA, Marks EC, Ryan ND, et al. High-intensity training in nonagenarians: effects on skeletal muscle. JAMA. 1990;263:3029-3034. (Pubitemid 20181606)
53. Johnson LE, Dooley PA, Gleick JB. Oral nutritional supplement use in elderly nursing home patients. J Am Geriatr Soc. 1993;41:947-952. (Pubitemid 23262321)
54. Elmstahl S, Steen B. Hospital nutrition in geriatric long-term care medicine: II. Effects of dietary supplements. Age Ageing. 1987;16:73-80. (Pubitemid 17028316)
55. Wilson MM, Purushothaman R, Morley JE. Effect of liquid dietary supplements on energy intake in the elderly. Am J Clin Nutr. 2002;75:944-947. (Pubitemid 34441265)
56. Moertel C, Schutt AG, Reitemeier RJ, et al. Corticosteroid therapy of pre-terminal gastrointestinal cancer. Cancer. 1974;33:1607-1609.
57. Willox J, Corr J, Shaw J, et al. Prednisolone as an appetite stimulant in patients with cancer. Br Med J (Clin Res Ed). 1984;288:27. (Pubitemid 14115332)
58. Bruera E. Roca E, Cedaro L, et al. Action of oral methylprednisolone in terminal cancer patients: a prospective randomized double blind study. Cancer Treat Rep. 1985;69:751-754. (Pubitemid 15229409)
59. Della Cuna GR, Pellegrini A, Piazzi M. Effect of methylprednisolone sodium succinate on quality of life in preterminal cancer patients: a placebo controlled multicenter study. Eur J Cancer Clin Oncol. 1989;25:1817-1821. (Pubitemid 20084182)
60. Popiela T, Lucchi R, Giongo F. Methlyprednisolone as palliative therapy for female terminal cancer patients. Eur J Cancer Clin Oncol. 1989;25;1823-1824.
61. Kardinal C. Loprinzi CL, Schaid DJ, et al. A controlled trial of cyproheptadine in cancer patients with anorexia and/or cachexia. Cancer. 1990;65:2657-2662. (Pubitemid 20179539)
62. Plasse TF, Gorter RW, Krasnow SH, et al. Recent clinical experience with dronabinol. Pharmacol Biochem Behav. 1991;40:695-700.
63. Nelson K, Walsh D, Deeter P, et al. A phase II study of delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. J Palliat Care. 1994;10:14-18.
64. Beal JE, Olson R, Lefkowitz L, et al. Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia. J Pain Symptom Manage. 1997;14:7-14. (Pubitemid 27287406)
65. Mantovani G, Maccio A, Bianchi A, et al. Megestrol acetate in neoplastic anorexia/cachexia: clinical evaluation and comparison with cytokine levels in patients with head and neck carcinoma treated with neoadjuvant chemotherapy. Int J Clin Lab Res. 1995;25:135-141.
66. Reyes-Teran G, Sieira-Madero JG, Martinez del Cerro V, et al. Effects of thalidomide on HIV-associated wasting syndrome: a randomized, double-blind, placebocontrolled clinical trial. AIDS. 1996;10:1501-1507. (Pubitemid 26370663)
67. Schambelan M, Mulligan K, Grunfeld C, et al. Recombinant human growth hormone in patients with HIV-associated wasting: a randomized, placebo- controlled trial. Ann Intern Med. 1996;125:873-872.
68. Kaiser FE, Silver AJ, Morley JE. The effect of recombinant human growth hormone on malnourished older individuals. J Am Geriatr Soc. 1991;39:235-240.
69. Snyder PJ, Peachey H, Berlin JA, et al. Effects of testosterone replacement in hypogonadal men. J Clin Endocrinol Metab. 2000;85:2670-2677. (Pubitemid 32269134)
70. Morley JE, Perry HM 3rd, Kaiser FE, et al. Effects of testosterone replacement therapy in old hypogonadal males: a preliminary study. J Am Geriatr Soc. 1993;41:149-152. (Pubitemid 23051423)
71. Sih R, Morley JE. Kaiser FE, et al. Testosterone replacement in older hypogonadal men: a 12-month randomized controlled trial. J Clin Endocrinol Metab. 1997;82:1661-1667. (Pubitemid 127495166)
72. Bakhshi V, Elliott M, Gentili A, et al. Testosterone improves rehabilitation outcomes in ill older men. J Am Geriatr Soc. 2000;48:550-553. (Pubitemid 30263108)
73. Hengge UR, Baumann M, Maleba R, et al. Oxymetholone promotes weight gain in patients with advance human immunodeficiency vires (HIV-1) infection. Br J Nutr. 1996;75:129-138. (Pubitemid 26059372)
74. Pengelly CD. Oxymetholone in the chemotherapy of malignant disease. Curr Med Res Opin. 1973;1:401-406.
75. Pascual Lopez A, Roque i Figuls M, Urrutia Cucchi G, et al. Systematic review of megestrol acetate in the treatment of anorexia-cachexia syndrome. J Pain Symptom Manage. 2004;27:360-369.
76. Berenstein G, Ortiz Z. Megestrol acetate for treatment of anorexia-cachexia syndrome. Cochrane Database Syst Rev. 2005;2:CD004310.
77. Yeh SS, Wu SY, Lee TP, et al. Improvement in quality-of-life measures and stimulation of weight gain after treatment with megestrol acetate oral suspension in geriatric cachexia: Results of a double-blind, placebo-controlled study. J Am Geriatr Soc. 2000;48:485-492.
78. Karcic E, Philpot C, Morley JE. Treating malnutrition with megestrol acetate: literature review and review of our experience. J Nutr Health Aging. 2002;6:191-200. (Pubitemid 34625301)
79. Simmons SF, Walker KA, Osterweil D. The effect of megestrol acetate on oral food and fluid intake in nursing home residents: a pilot study. J Am Med Dir Assoc. 2004;5:24-30. (Pubitemid 38128663)
80. Burrowes JD, Bluestone PA, Wang J, PiersonRNJr. The effects of moderate doses of megestrol acetate on nutritional status and body composition in a hemodialysis patient. J Ren Nutr. 1999;9:89-94.
81. Rammohan M, Kalantar-Zadeh K, Liang A, Ghossein C. Megestrol acetate in a moderate dose for the treatment of malnutrition-inflammation complex in maintenance dialysis patients. J Ren Nutr. 2005;15:345-355. (Pubitemid 40917294)
82. Ashby DR, Ford HE, Wynne KJ, et al. Sustained appetite improvement in malnourished dialysis patients by daily ghrelin treatment. Kidney Int. 2009;76:199-206.
83. Barber MD, Ross JA, Voss AC, et al. The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer. Br J Cancer. 1999;81:80-86. (Pubitemid 29415495)
84. Batterham MJ, Garsia R. A comparison of megestrol acetate, nandrolone decanoate and dietary counselling for HIV associated weight loss. Int J Androl. 2001;24:232-240. (Pubitemid 32675090)
85. Jatoi, A, Windschitl HE, Loprinzi CL, et al. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. J Clin Oncol. 2002;20:567-573. (Pubitemid 34072541)
86. Jatoi A, Rowland K, Loprinzi CL, et al. An eicosapentaenoic acid supplement versus megestrol acetate versus both for patients with cancer-associated wasting: a North Central Cancer Treatment Group and National Cancer Institute of Canada collaborative effort. J Clin Oncol. 2004;22:2469-2476. (Pubitemid 41115406)
87. Yeh SS, Wu SY, Levine DM, et al. The correlation of cytokine levels with body weight after megestrol acetate treatment in geriatric patients. J Gerontol A Biol Sci Med Sci. 2001;56:M48-M54. (Pubitemid 32042969)
88. Yeh SS, Hafner A, Schuster MW, et al. Relationship between body composition and cytokines in cachectic patients with chronic obstructive pulmonary disease. J Am Geriatr Soc. 2003;51:890-891. (Pubitemid 36693450)
89. Ridker PM, Cannon CP, Morrow D, et al. C-reactive protein levels and outcomes after statin therapy. N Engl J Med. 2005;352:20-28. (Pubitemid 40075677)
90. Sliwa K, Woodiwiss A, Kone VN, et al. Therapy of ischemic cardiomyopathy with the immunomodulating agent pentoxifylline: results of a randomized study. Circulation. 2004;109:750-755. (Pubitemid 38222895)
91. Bahrmann P, Hengst UM, Richartz BM, Figulla HR. Pentoxifylline in ischemic, hypertensive and idiopathic-dilated cardiomyopathy: effects on left-ventricular function, inflammatory cytokines and symptoms. Eur J Heart Fail. 2004;6:195-201. (Pubitemid 38249363)
92. Yarasheski KE. Growth hormone effects on metabolism, body composition, muscle mass, and strength. Exerc Sport Sci Rev. 1994;22:285-312.
93. Takala J, Ruokonen E, Webster NR, et al. Increased mortality with growth hormone treatment in critically ill adults. N Enlg J Med. 1999;341:785-792. (Pubitemid 29420473)
94. Anadrol-50 [package insert]. Marietta, Ga: Alaven Pharmaceutical LLC; 2006.
95. Loprinzi C, Jensen M, Jiang N, Schaid DJ. Effect of megestrol acetate on the human pituitary-adrenal axis. Mayo Clin Proc. 1992;67:1160-1162.
96. Koller E, Gibert C, Green L, et al. Thrombotic events associated with megestrol acetate in patients with AIDS cachexia. Nutrition. 1999;15:294-298. (Pubitemid 29201096)
97. Spitzer WO, Lewis MA, Heinemann LA, et al. Third generation oral contraceptives and risk of venous thrombotic disorders: an international case control study. Transnational Research Group on Oral Contraceptives and the Health of Young Women. BMJ. 1996:312-383.
98. Hansson PO, Welin L, Tibblin G, et al. Deep vein thrombosis and pulmonary embolism in the general population. Arch Intern Med. 1997;157:1665-1670. (Pubitemid 27327401)
99. Kniffin WD Jr, Baron JA, Barrett J, et al. The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med. 1992;232:155-160.
100. Thomas DR. Incidence of venous thromboembolism in megestrol acetate users. J Am Med Dir Assoc. 2004;5:65-67. (Pubitemid 38128673)
101. Volicer L, Stelly M, Morris J, et al. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease. Int J Geriatr Psychiatry. 1997;12:913-919. (Pubitemid 27420571)
102. Fearon KC, Von Meyenfeldt MF, Moses AG, et al. Effect of a protein and energy dense N-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial. Gut. 2003;52:1479-1486. (Pubitemid 37176729)
103. Loprinzi CL, Kuross SA, O'Fallon JR, et al. Randomized placebo-controlled evaluation of hydrazine sulfate in patients with advanced colorectal cancer. J Clin Oncol. 1994;12:1121-1125. (Pubitemid 24173923)
104. Bruera E, Macmillan K, Kuehn N, et al. A controlled trial of megestrol acetate on appetite, caloric intake, nutritional status, and other symptoms in patients with advance cancer. Cancer. 1990;66:1279-1282. (Pubitemid 20310671)
105. Loprinzi CL, Ellison NM, Schaid DJ, et al. Controlled trial of megestrol acetate for the treatment of cancer, anorexia and cachexia. J Natl Cancer Inst. 1990; 82:1127-1132. (Pubitemid 20213253)
106. Schmoll E, Wilke H, Thole R, et al. Megestrol acetate in cancer cachexia. Semin Oncol. 1991;18(Suppl 2):32-34.
107. Heckmayr M, Gatzemeier U. Treatment of cancer weight loss in patients with advanced lung cancer. Oncology. 1992;49(Suppl 2):32-34.
108. Feliu J, Gonzalez-Baron M, Berrocal A. Usefulness of megestrol acetate in cancer cachexia and anorexia. Am J Clin Oncol. 1992;15:436-440.
109. Azcona C, Castro L, Crespo E, et al. Megestrol acetate therapy for anorexia and weight loss in children with malignant solid tumors. Aliment Pharmacol Ther. 1996;10:577-586. (Pubitemid 26259623)
110. Tchekmedyian S, Hakman M, Siau J, et al. Megestrol acetate in cancer anorexia and weight loss. Cancer. 1992;69:1268-1274.
111. Beller E, Tattersail M, Lumley T, et al. Improved quality of life with megestrol acetate in patients with endocrinein-sensitive advanced cancer: a randomized placebo-control trial. Ann Oncol. 1997;8:277-283. (Pubitemid 27153495)
112. Bruera E, Ernst S, Hagen N, et al. Symptomatic effects of megestrol acetate (MA): a double-blind, crossover study [abstract]. Proceedings of the American Society of Clinical Oncology; 1996:Abstract 1716.
113. Fietkau R, Riepl M, Kettner H, et al. Supportive use of megestrol acetate in patients with head and neck cancer during radio(chemo)therapy. Eur J Cancer. 1997;33:75-79. (Pubitemid 27099571)
114. McMillan DC, Wigmore SJ, Fearon KC, et al. A prospective randomized study of megestrol acetate and ibuprofen in gastrointestinal cancer patients with weight loss. Br J Cancer. 1999;79:495-500. (Pubitemid 29046225)
115. Gebbia V, Testa A, Gebbia N. Prospective randomized trial of two dose levels of megestrol acetate in the management of anorexia-cachexia syndrome in patients with metastatic cancer. Br J Cancer. 1996;73:1576-1580. (Pubitemid 26235387)
116. Loprinzi CL, Kugler JW, Sloan JA, et al. Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol. 1999;17:3299-3306. (Pubitemid 29470666)
117. Jeanfaivre T, Souday V, Chaleil D, et al. Phase II trial evaluating the effect of megestrol acetate-prednisolone combination in the treatment of anorexia during the palliative-care phase of lung cancer [in French]. Rev Pneumol Clin. 2000;56:255-260.
118. Von Roenn JH, Armstrong D, Kotler DP, et al. Megestrol acetate in patients with AIDS-related cachexia. Ann Intern Med. 1994;121:393-399.
119. Oster MH, Enders SR, Samuels SJ, et al. Megestrol acetate in patients with AIDS and cachexia. Ann Intern Med. 1994;121:400-408.
120. Lien YH, Ruffenach SJ. Low dose megestrol increases serum albumin in malnourished dialysis patients. Intl J Artif Organs. 1996;19:147-150. (Pubitemid 26088524)
121. Antoniu SA. Effects of inhaled therapy on biomarkers of systemic inflammation in stable chronic obstructive pulmonary disease. Biomarkers 2010;15:97-103.
122. Takatsuka H, Takemoto Y, Iwata N, et al. Oral eicosapentaenoic acid for complications of bone marrow transplantation. Bone Marrow Transplant. 2001;28:769-774. (Pubitemid 33085570)