Carnitine and Celecoxib in Combination May Be Effective in Treating Patients with Cancer-related Anorexia/Cachexia Syndrome
Study authors compared a two-drug combination (including nutraceuticals, i.e. antioxidants) with carnitine + celecoxib +/- megestrol acetate for the treatment of cancer-related anorexia/cachexia syndrome (CACS). The primary endpoints were increase of lean body mass (LBM) and improvement of total daily physical activity of this phase III, randomized non-inferiority study. Secondary endpoint was increase of physical performance, tested by grip strength and 6-min walk test. Subjects (n=60) were randomly assigned to: arm 1, L-carnitine 4 g/day + Celecoxib 300 mg/day or arm 2, L-carnitine 4 g/day + celecoxib 300 mg/day + megestrol acetate 320 mg/day, all orally. All patients received as basic treatment polyphenols 300 mg/day, lipoic acid 300 mg/day, carbocysteine 2.7 g/day, Vitamin E, A, C. Treatment duration was 4 months. Results did not show a significant difference between treatment arms in both primary and secondary endpoints. Analysis of changes from baseline showed that LBM (by dual-energy X-ray absorptiometry and by L3 computed tomography) increased significantly in both arms as well as physical performance assessed by 6MWT. Toxicity was quite negligible and comparable between arms. Results showed a two-drug approach could be suggested in the clinical practice to implement CACS treatment.
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