title: Ghrelin administration for chronic respiratory failure: a randomized dose-comparison trial.
abstract: BACKGROUND
  Repeated ghrelin administration leads to improvements in symptoms, muscle wasting and exercise tolerance in cachectic patients with pulmonary disease. We investigated the optimal ghrelin dose for underweight patients with chronic respiratory failure.
  
  
  METHODS
  In this multicenter, randomized, dose-comparison exploratory study, 44 cachectic patients with chronic respiratory failure were randomly assigned pulmonary rehabilitation with intravenous twice-daily administration of 1 or 2 μg/kg ghrelin for 3 weeks. The primary endpoint was improvement in 6-min walking distance (6 MWD). The secondary endpoint was change in peak VO2.
  
  
  RESULTS
  Twenty-one patients were assigned to the 1 μg/kg ghrelin group and 23 to the 2 μg/kg ghrelin group. Change from baseline 6 MWD after treatment was similar between groups(1 μg/kg: 53.9 m, 2 μg/kg: 53.9 m, p = 0.99). Mean change in peak VO2 was significantly greater in the 2 μg/kg group (63.1 ml/min) than in the 1 μg/kg group (-63.8 ml/min, p = 0.048). Food intake and lean body mass significantly increased in both groups, and the St. George Respiratory Questionnaire score, body weight, and body mass index were remarkably improved in only the 2 μg/kg group, although there was no significant difference between groups. No treatment-related serious events were reported for either group.
  
  
  CONCLUSIONS
  Improvements in the oxygen uptake capacity were greater in patients receiving 2 μg/kg ghrelin twice daily for 3 weeks than in those receiving 1 μg/kg, although exercise tolerance was similar between groups at the end of the 3-week treatment period. Thus, a twice daily dose of 2 μg/kg ghrelin is recommended over 1 μg/kg ghrelin for patients with chronic respiratory failure and weight loss.
authors: Neurology, Respirology, Endocrinology and Metabolism, Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan, nobuhiro@med.miyazaki-u.ac.jp.
authors: Nobuhiro
authors: N
authors: Matsumoto
authors: Keisuke
authors: K
authors: Miki
authors: Hironobu
authors: H
authors: Tsubouchi
authors: Akihiro
authors: A
authors: Sakamoto
authors: Yasuji
authors: Y
authors: Arimura
authors: Shigehisa
authors: S
authors: Yanagi
authors: Hirotoshi
authors: H
authors: Iiboshi
authors: Makoto
authors: M
authors: Yoshida
authors: Ryosuke
authors: R
authors: Souma
authors: Hiroshi
authors: H
authors: Ishimoto
authors: Yoshifumi
authors: Y
authors: Yamamoto
authors: Kazuhiro
authors: K
authors: Yatera
authors: Masanori
authors: M
authors: Yoshikawa
authors: Hironori
authors: H
authors: Sagara
authors: Tomoaki
authors: T
authors: Iwanaga
authors: Hiroshi
authors: H
authors: Mukae
authors: Ryoji
authors: R
authors: Maekura
authors: Hiroshi
authors: H
authors: Kimura
authors: Masamitsu
authors: M
authors: Nakazato
authors: Kenji
authors: K
authors: Kangawa
mesh_terms: D000368:Aged; D001823:Body Composition; D001835:Body Weight; D002100:Cachexia / Q000150:complications*; D002908:Chronic Disease; D004435:Eating; D002149:Energy Intake; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D054439:Ghrelin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000150:complications* / Q000188:drug therapy* / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D016138:Walking
chemical_list: D054439:Ghrelin
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