Anorexia, Cachexia, Weight Loss
Conditions
Keywords
Megestrol acetate, Anorexia, Cachexia, Cancer, Unintended weight loss, Body weight, Appetite, Megace ES
Brief summary
To compare the effect of megestrol acetate concentrated suspension and placebo on caloric intake in patients with cancer-associated anorexia.
Interventions
Megestrol acetate concentrated suspension 110 mg/mL given as an oral dose of 550 mg (5 mL) once per day for 56 days, with an optional 28 days extension phase
DRUGMegestrol acetate concentrated suspension 60 mg/mL
Megestrol acetate concentrated suspension 60 mg/mL given as an oral dose of 300 mg (5 mL) once per day for 56 days, with an optional 28 days extension phase
DRUGPlacebo
Placebo oral suspension, 5 mL once daily
Sponsors
PRA Health Sciences
Par Pharmaceutical, Inc.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Cancer of multiple types in stage II, III, or IV and not a candidate for chemotherapy; but may have been receiving radiation therapy * Fair, poor, or very poor appetite * Cancer-associated anorexia/cachexia (documented weight loss of 2% over the prior week, or at least 5% within past 30 days, or at least 7.5% over prior 3 months, or at least 10% over prior 6 months) * Weight loss perceived to be associated with diminished appetite * Eastern Cooperative Oncology Group Performance score of 0, 1, or 2 * Life expectancy greater than 3 months * Alert and mentally competent to complete study assessments * Women of child-bearing potential required to use an adequate and reliable method of contraception. Post-menopausal women have to have been so for at least 1 year * Screening laboratory values must not be clinically significant (some exceptions per protocol)
Exclusion criteria
* Brain, or head and neck tumors that may interfere with food consumption * AIDS-related wasting * Radiation therapy to head and neck, abdomen, or pelvis within past 6 weeks, or for whom radiation therapy is anticipated during the study such that the result may interfere with food consumption * Presence of conditions that interfere with oral intake or ability to swallow * Absence of normally functioning gut * Known mechanical obstruction of the alimentary or biliary tract, or malabsorption syndrome * Intractable or frequent vomiting * Clinically significant diarrhea * History of thromboembolic events, or on long-term anticoagulation for thromboembolism * Uncontrolled diabetes mellitus, or symptomatic hypoadrenalism * Poorly controlled hypertension or congestive heart failure * Pregnant/lactating females, or planning on becoming pregnant * Use of appetite stimulants within past 30 days * Use of parenteral nutrition or tube feedings within past 1 week * Chronic use of steroids within past 3 months (intermittent short-term use allowed) * Current use of illicit substances * Allergy, hypersensitivity, or other contraindication to megestrol acetate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Average Daily Caloric Intake Over the Course of the 8-week Double-blind Phase | 8 weeks | The Nutrition Data System for Research (NDSR) was used to determine nutrient and caloric value for foods and beverages consumed and recorded by subjects over a 3-day assessment period prior to each visit. Total number of calories consumed during each 3-day assessment was averaged over available values to determine the week's daily caloric intake value. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Weight Over the Course of the 8-week Double-blind Phase | Baseline, Week 1, 2, 3, 4, 6, and 8 | — |
| Changes in Body Composition as Measured by Bioelectric Impedance Analysis (BIA) at Week 4 and Week 8 Relative to Baseline | Baseline, Week 4 and Week 8 | — |
| Change in Appetite Over the 8-week Double-blind Phase as Measured by a VAS Appetite Scale | Baseline, Weeks 1, 2, 3, 4, 6 and 8 | Subjects marked 6 items on a visual analog scale (VAS) appetite scale including feeling not hungry to hungry, not nauseated to nauseated, empty to full, not satiated to satiated; weak to strong desire to eat; and ability to eat none to a large amount of food |
Countries
United States
Participant flow
Pre-assignment details
After screening, eligible subjects were randomized to treatment in the double-blind phase. After completing the double-blind phase or discontinuing due to specific weight loss criteria, eligible subjects could enter an open-label extension phase.
Participants by arm
| Arm | Count |
|---|---|
| DB MA-CS 550 mg/Day MA-CS (110 mg/mL) administered orally q24h, for a daily dose of 550 mg per day (5 mL dose) in the 8-week DB phase | 2 |
| DB MA-CS 300 mg/Day MA-CS (60 mg/mL) administered orally q24h, for a daily dose of 300 mg per day (5 mL dose) in the 8-week DB phase | 0 |
| DB Placebo Placebo suspension administered orally q24h (5 mL dose) in the 8-week DB phase | 2 |
| Total | 4 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Double-blind Phase | Study Discontinued | 2 | 0 | 1 | 0 |
| Extension Phase | Study Discontinued | 0 | 0 | 0 | 1 |
Baseline characteristics
| Characteristic | DB MA-CS 550 mg/Day | DB Placebo | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 participants | 0 participants | 0 participants |
| Age, Categorical >=65 years | 1 participants | 2 participants | 3 participants |
| Age, Categorical Between 18 and 65 years | 1 participants | 0 participants | 1 participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 participants | 0 participants | 0 participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 2 participants | 2 participants | 4 participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 participants | 0 participants | 0 participants |
| Gender Female | 1 participants | 0 participants | 1 participants |
| Gender Male | 1 participants | 2 participants | 3 participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 participants | 0 participants | 0 participants |
| Race (NIH/OMB) Asian | 0 participants | 1 participants | 1 participants |
| Race (NIH/OMB) Black or African American | 0 participants | 0 participants | 0 participants |
| Race (NIH/OMB) More than one race | 0 participants | 0 participants | 0 participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 participants | 0 participants | 0 participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 participants | 0 participants | 0 participants |
| Race (NIH/OMB) White | 2 participants | 1 participants | 3 participants |
| Region of Enrollment United States | 2 participants | 2 participants | 4 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 1 / 2 | 0 / 0 | 2 / 2 | 1 / 1 |
| serious Total, serious adverse events | 0 / 2 | 0 / 0 | 1 / 2 | 1 / 1 |
Outcome results
Primary
Average Daily Caloric Intake Over the Course of the 8-week Double-blind Phase
The Nutrition Data System for Research (NDSR) was used to determine nutrient and caloric value for foods and beverages consumed and recorded by subjects over a 3-day assessment period prior to each visit. Total number of calories consumed during each 3-day assessment was averaged over available values to determine the week's daily caloric intake value.
Time frame: 8 weeks
Population: Results not analyzed due to early termination of the study
Secondary
Change in Appetite Over the 8-week Double-blind Phase as Measured by a VAS Appetite Scale
Subjects marked 6 items on a visual analog scale (VAS) appetite scale including feeling not hungry to hungry, not nauseated to nauseated, empty to full, not satiated to satiated; weak to strong desire to eat; and ability to eat none to a large amount of food
Time frame: Baseline, Weeks 1, 2, 3, 4, 6 and 8
Population: Results not analyzed due to early termination of the study
Secondary
Change in Weight Over the Course of the 8-week Double-blind Phase
Time frame: Baseline, Week 1, 2, 3, 4, 6, and 8
Population: Results not analyzed due to early termination of the study
Secondary
Changes in Body Composition as Measured by Bioelectric Impedance Analysis (BIA) at Week 4 and Week 8 Relative to Baseline
Time frame: Baseline, Week 4 and Week 8
Population: Results not analyzed due to early termination of the study