Study summary · research use only
Pharmacotherapy in Cachexia: A Review of Endocrine Abnormalities and Steroid Pharmacotherapy
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This review discusses endocrine abnormalities and pharmacotherapy, including steroid treatment, in cachexia. The abstract describes cachexia as a state of increased metabolism linked to cytokine and hormone dysregulation causing reduced protein synthesis and excessive protein breakdown, addressed with pharmacological treatment alongside nutritional support and physical activity. It states pharmacological treatment aims to reduce inflammation, improve appetite, and decrease muscle wasting, citing agents targeting cytokines such as interferon-α and tumor necrosis factor-β, plus corticosteroids, resveratrol, estrogen analogs, progesterone analogs, testosterone analogs, selective androgen receptor modulators (SARM), ACE inhibitors, NSAIDs, thalidomide, melatonin, and Growth Hormone Releasing Peptide-2 (GHRP-2), noting evidence-based recommendations are not available for some of these. Species not specified.
Abstract
Cachexia is a state of increased metabolism associated with high morbidity and mortality. Dysregulation of cytokines and hormone activity causes reduced protein synthesis and excessive protein breakdown. various treatments are available, depending on the primary disease and the patient's state. Besides pharmacological treatment, crucial is nutritional support as well as increasing physical activity. The main purpose of pharmacological treatment is to diminish inflammation, improve appetite and decrease muscle wasting. Therefore a lot of medications aim at proinflammatory cytokines such as Interferon-α or Tumor Necrosis Factor-β, but because of the complicated mechanism of cachexia, the range of targets is very wide. in cachexia treatment, use of corticosteroids is common, which improve appetite, diminish inflammation, inhibit prostaglandin metabolism, Interleukin-1 activity. They can also decrease protein synthesis and increase protein degradation, which can be prevented by resveratrol. Estrogen analogs, progesterone analogs, testosterone analogs, Selective Androgen Receptor Modulators (SARM), Angiotensin-Converting-Enzyme Inhibitors (ACEI), Nonsteroidal anti-inflammatory drugs (NSAIDs), thalidomide, melatonin, Growth Hormone Releasing Peptide-2 (GHRP-2) may play important role in wasting syndrome treatment as well. However, for the usage of some of them, evidence-based recommendations are not available. This review highlights current therapeutic options for cachexia with a specific focus on steroid therapy.
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