Opportunistic Infections & Other Complications: Weight loss


Opportunistic Infections & Other Complications: Weight loss

Seattle Treatment Education Project (STEP) Perspective, Vol. 5, No. 2 - July 1993 * 127 Broadway E. Ste 200 Seattle, WA 98102
Laury McKean, RN

Megestrol acetate (Megace) is commonly used to treat individuals with cachexia (wasting). Data was presented from a randomized, double-blind study comparing high-dose megestrol acetate and placebo in 100 individuals with AIDS and severe cachexia. The participants had documented weight loss of at least 10% of ideal body weight. Forty-eight received placebo and 52 received 800 mg of a liquid formulation of megestrol acetate for 12 weeks. Side effects were minimal and comparable in the two groups. Individuals in the treatment group had significantly improved sense of well-being, caloric intake and body weight compared to the placebo group. Body composition analysis showed that the weight gain in the treatment group was primarily due to a gain in fat mass. Additionally, at weeks eight and 12, individuals receiving megestrol acetate had a significant increase in CD4 cells (mean increase 69) (PO-B36-2360).

A French study assessed the efficacy of medoxyprogesterone acetate (mpa) for weight gain and appetite stimulation. Fifty-two individuals who had lost more than 10% of their pre-illness weight were enrolled. Before starting therapy, the mean weight loss was 8.97 kg (range of four to 16 kg). The participants received 400 mg a day orally of mpa for two months. Weight loss continued in 9% of the participants. Weight gain was seen in 81% of the individuals, with an average gain of 6.32 kg. The median time to peak weight on mpa was 9.8 weeks. Of these individuals, 28% returned to or exceeded their pre-illness weight. All participants tolerated mpa well and no drug related impotence or peripheral edema occurred (PO-B36-2352).

A German study presented data on the use of Anapolon (oxymethadone) in the treatment of cachexia. Anapolon is a progesterone derivative which has been associated with appetite stimulation and weight gain. The 24 study participants had lost at least 10% of their pre-illness weight, with the mean loss being 11.7 kg (range of six to 20 kg). The individuals received 50 mg of Anapolon three times a day orally. They also received 50 mg twice a day of ketotifen, which was recently shown to block tnf-a. Preliminary data was presented on 22 of the participants. who were observed from 10 to 36 weeks. Eighteen of the 22 (81%) gained an average of 5.2 kg after a mean treatment of 3.9 weeks. Three participants did not respond and one individual continued to lose weight. Improved appetite was reported in 20 of the 22 (91%) participants and weakness improved in most. tnf-a levels decreased in about 14% of the people. The drug was well tolerated by all the participants. Two individuals reported increased fatigue, and one developed impotence (PO-B19-1844).

This concludes our coverage of the IX International AIDS Conference in Berlin. Please call the STEP office if you have any questions or would like reprints of any articles in this issue.
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Always watch for outdated information. This article first appeard in 1993. This material is designed to support, not replace, the relationship that exists between you and your doctor.

Copyright © 1993 - Seattle Treatment Education Project (STEP) - All rights reserved. Noncommercial reproduction is encouraged. STEP is published four times a year by the Seattle Treatment Education Project, 127 Broadway East, 3rd Floor, Seattle, WA 98102.    Email: step100@aol.com  STEP web page

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1993. AEGIS.