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Mirtazapine versus Megestrol in the Treatment of Anorexia–Cachexia Syndrome in Patients with Advanced Cancer: A Randomized, Double-Blind, Controlled Phase II Clinical Trial

醋酸甲地孕酮 米氮平 厌食症 医学 恶病质 甲地孕酮 食欲 内科学 体重增加 随机对照试验 减肥 癌症 不利影响 抗抑郁药 体重 肥胖 海马体
作者
Olga Laura Sena Almeida,Eduardo Ferriolli,Roberta Cristina Cintra Taveira,Meire Gallo Rosenburg,Daniela Dalpubel Campanari,Natália Maíra da Cruz Alves,Karina Pfrimer,Liane Rapatoni,Fernanda Maris Peria,Nereida K. C. Lima
出处
期刊:Cancers [Multidisciplinary Digital Publishing Institute]
卷期号:15 (14): 3588-3588
标识
DOI:10.3390/cancers15143588
摘要

This study compared mirtazapine with megestrol in the management of cancer-related anorexia-cachexia syndrome in patients with advanced cancer. A randomized, double-blind, controlled clinical trial involving patients with advanced cancer and anorexia-cachexia syndrome was performed. Participants received mirtazapine 30 mg/day or megestrol 320 mg/day for eight weeks. The primary endpoint was the effect of mirtazapine on weight gain and the secondary endpoints were its effect on appetite, muscle strength, physical performance, body composition, adverse events, and medication adherence. Linear regression model with mixed effects was applied and a significance level of 5% was adopted. Fifty-two patients were randomized. Mean age was 65.8 ± 8.4 years. There was weight gain in 52% of the participants in the megestrol group and in 38% in the mirtazapine group after four weeks (p = 0.040). Appetite improved in 92% of the participants in the megestrol group and in 56% in the mirtazapine group after eight weeks (p = 0.007). In the sub-analysis by sex, women showed improvement in appetite (p < 0.001) and weight gain (p < 0.005) in the mirtazapine group, which was not observed in men. Mirtazapine appears to be inferior to megestrol in weight and appetite improvement. However, there may be a difference in the therapeutic response between sexes.
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