title: [Low doses of megestrol acetate increase weight and improve nutrition status in patients with severe chronic obstructive pulmonary disease and weight loss].
abstract: OBJECTIVE
  Weight loss in patients with severe chronic obstructive pulmonary disease (COPD) is a prognostic bad factor. The objective of this study is to analyze the effectively of megestrol acetate (MA) to increase appetite of these patients.
  
  
  METHODS
  Randomized double blind placebo controlled trial to study the effect of 160 mg/bid of MA, for 8 weeks, on nutritional, functional, analytical and quality of life parameters, in 38 patients with severe COPD and body mass index (BMI) < 21 kg/m(2), or between 21-25 with involuntary weight loss of 5% in the last 3 months.
  
  
  RESULTS
  At 8 weeks, in the MA group the body weight increased (2.3 kg) with respect to the control group (0.1 kg) (p<0.04). MA improved significantly the triceps skin-fold thickness (p < 0.04), prealbumin (p<0.004), lymphocytes (p<0.0006), C3 (p<0.04), PCO(2) (p<0.007) and bicarbonate levels (p<0.008). MA did not increase the MRC and SGRQ scales, the distance of 6 MWT nor BODE index. The IL-6 and TNF alpha levels were not modified in the MA group, but leptin did increase (p<0.043). MA improved the sense of wellbeing (p<0.02) and the appetite (p<0.008), compared to the control group. Adverse effects were similar in both groups.
  
  
  CONCLUSIONS
  MA safely increases the body weight and the appetite in severe COPD patients with weight loss. MA improves blood gases and nutritional parameters and the sense of wellbeing, but it does not improve the respiratory muscular function or exercise tolerance.
authors.affiliation: Servicio de Neumología, Hospital Universitario Dr. Peset, Valencia, España. herrejon_alb@gva.es
authors.forename: Alberto
authors.initials: A
authors.lastname: Herrejón
authors.forename: Julio
authors.initials: J
authors.lastname: Palop
authors.forename: Ignacio
authors.initials: I
authors.lastname: Inchaurraga
authors.forename: Antonio
authors.initials: A
authors.lastname: López
authors.forename: Celia
authors.initials: C
authors.lastname: Bañuls
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández
authors.forename: Rafael
authors.initials: R
authors.lastname: Blanquer
authors.forename: Nuria
authors.initials: N
authors.lastname: Están
authors.forename: Anna
authors.initials: A
authors.lastname: Anguera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001066:Appetite / Q000187:drug effects; D019167:Appetite Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001639:Bicarbonates / Q000097:blood; D001835:Body Weight / Q000187:drug effects; D002100:Cachexia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D019290:Megestrol Acetate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects*; D011228:Prealbumin / Q000032:analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications*; D011788:Quality of Life; D012885:Skinfold Thickness; D013739:Testosterone / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D019167:Appetite Stimulants; D001639:Bicarbonates; C508600:IL6 protein, human; D015850:Interleukin-6; D020738:Leptin; D011228:Prealbumin; D014409:Tumor Necrosis Factor-alpha; D013739:Testosterone; D019290:Megestrol Acetate; D006854:Hydrocortisone