• 作者：Alberto Herrej43 ; n^a ; ^{herrejon_alb@gva.es} ; Julio Palop^a ; Ignacio Inchaurraga^a ; Antonio L43 ; pez^b ; Celia Bañ ; uls^b ; Antonio Hern25 ; ndez^b ; Rafael Blanquer^a ; Nuria Est25 ; n^c ; Anna Anguera^d
• 关键词：Acetato de megestrol ; Enfermedad pulmonar obstructiva cró ; nica ; Pé ; rdida de peso ; Anorexia ; Caquexia
• 刊名：Medicina Cl铆nica
• 出版年：2011
• 期刊代码：pca254_00257753
• 类别：med
• 出版时间：23 July 2011
• 卷：137
• 期：5
• 页码：193-198
• 文件大小：223 K

Background and objetive

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.

Patients and 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/m², 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), PCO₂ (p < 0.007) and bicarbonate levels (p < 0.008). MA did not increase the MRC and SGRQ scales, the distance of 6MWT 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.