title: Megestrol acetate in patients with AIDS-related cachexia.
abstract: OBJECTIVE
  To compare the effects of oral suspensions of megestrol acetate, 800 mg/d, and placebo on body weight in patients with acquired immunodeficiency syndrome (AIDS)-related weight loss.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Outpatient community and university patient care setting.
  
  
  METHODS
  Consecutive patients with AIDS who had substantial weight loss and anorexia were enrolled. Of 271 patients, 270 and 195 were evaluable for safety and efficacy, respectively.
  
  
  METHODS
  Patients were randomly assigned to receive placebo or megestrol acetate (100 mg, 400 mg, or 800 mg) daily for 12 weeks.
  
  
  METHODS
  The primary efficacy criterion was weight gain. Patients were evaluated at 4-week intervals for changes in weight and body composition, caloric intake, sense of well-being, toxic effects, and appetite.
  
  
  RESULTS
  For evaluable patients receiving 800 mg of megestrol acetate per day, 64.2% gained 2.27 kg (5 pounds) or more compared with 21.4% of patients receiving placebo (P < 0.001). An intent-to-treat analysis showed significant differences (P = 0.002) between those receiving placebo and those receiving 800 mg of megestrol acetate for the number of patients who gained 2.27 kg (5 pounds) or more (8 of 32 [25%] compared with 38 of 61 [62.3%], respectively). Compared with patients receiving placebo at the time of maximum weight change, evaluable patients receiving megestrol acetate, 800 mg/d, reported improvement in overall well-being and had an increase in mean weight gain (-0.725 compared with 3.54 kg [-1.6 compared with +7.8 pounds]; P < 0.001), lean body mass (-0.772 compared with +1.14 kg [-1.7 compared with +2.5 pounds]; P < 0.001), appetite grade (P < 0.001), and caloric intake (-107 compared with +645.6 calories/d; P = 0.001).
  
  
  CONCLUSIONS
  In patients with AIDS-related weight loss, megestrol acetate can stimulate appetite, food intake, and statistically significant weight gain that is associated with a patient-reported improvement in an overall sense of well-being.
authors.affiliation: Northwestern University, Chicago, IL 60611.
authors.forename: J H
authors.initials: JH
authors.lastname: Von Roenn
authors.forename: D
authors.initials: D
authors.lastname: Armstrong
authors.forename: D P
authors.initials: DP
authors.lastname: Kotler
authors.forename: D L
authors.initials: DL
authors.lastname: Cohn
authors.forename: N G
authors.initials: NG
authors.lastname: Klimas
authors.forename: N S
authors.initials: NS
authors.lastname: Tchekmedyian
authors.forename: L
authors.initials: L
authors.lastname: Cone
authors.forename: P J
authors.initials: PJ
authors.lastname: Brennan
authors.forename: S A
authors.initials: SA
authors.lastname: Weitzman
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000523:psychology; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001823:Body Composition; D002100:Cachexia / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D017097:Electric Impedance; D002149:Energy Intake / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008535:Megestrol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019290:Megestrol Acetate; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D012649:Self Concept; D013997:Time Factors; D015430:Weight Gain / Q000187:drug effects
chemical_list: D008535:Megestrol; D019290:Megestrol Acetate