***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study was to evaluate a low-dose regimen of megestrol acetate ( MA ; 320 mg/day ) on appetite in advanced cancer patients . Out- patients with far-advanced non-hormone responsive tumours and loss of appetite were r and omised in a phase III trial , with two consecutive phases : a 14-day double-blind placebo controlled phase ( phase A ) and a 76-day open phase ( phase B ) . During phase A , patients were treated with MA , two 160 mg tablets/day , or placebo . In phase B , the MA dose was titrated to clinical response in both groups . Appetite , food intake , body weight , performance status , mood and quality of life were evaluated with st and ardised measures ; patients ' global judgement about treatment efficacy was also requested . Of 42 patients entering the study , 33 ( 17 MA and 16 placebo ) were evaluable for efficacy . The appetite score improved significantly with MA after 7 days ( P = 0.0023 ) , and this effect was still significant at 14 days ( P = 0.0064 ) . Patients judged the treatment with MA effective in 88.2 % of cases ( 14th day ) , whilst placebo was considered effective by 25 % ( P = 0.0003 ) . None of the other measures showed significant changes during treatment . The remarkable effect on appetite evident after 7 days , without serious side-effects , shows that MA can produce significant subjective effects at a low-dose even in patients with far-advanced disease Weight loss is known to impact survival among patients infected with human immunodeficiency virus ( HIV ) even in the era of highly active antiretroviral therapy ( HAART ) . In a r and omized trial , we compared the effects of 2 months of treatment with either megestrol acetate ( 800 mg every day ) or ox and rolone ( 10 mg twice per day ) on body weight and composition in patients with weight loss of > or = 5 kg who were receiving HAART . The mean weight was 66 kg , and the mean body mass index was 21 . Mean weight gain in the megestrol acetate and the ox and rolone arms were 2.8 kg ( 4.6 % of the baseline value ) and 2.5 kg ( 3.9 % of the baseline value ) , respectively ( P=.80 ) . Lean body mass accounted for 39 % of weight gain in the megestrol acetate arm and 56 % in the ox and rolone arm ( P=.38 ) . Seven patients in the megestrol acetate arm and 5 patients in the ox and rolone arm reported minor adverse events ( P=.74 ) . In conclusion , megestrol acetate therapy and ox and rolone therapy have similar effects on body weight and composition and are safe and well-tolerated during HAART BACKGROUND AND OBJECTIVE 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 R and omized 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/m(2 ) , 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 ) , PCO(2 ) ( p<0.007 ) and bicarbonate levels ( p<0.008 ) . MA did not increase the MRC and SGRQ scales , the distance of 6 MWT 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 Anorexia and cachexia are present in the majority of patients with advanced-stage cancer . Several agents have been tested for their ability to reverse weight loss in these patients . Megestrol acetate has been demonstrated to improve appetite and weight , independent of tumor response , when used in the treatment of metastatic breast cancer . Several trials have studied the ability of megestrol acetate to stimulate weight gain in patients with non-hormone-sensitive tumors . One hundred fifty patients with a weight lost of more than 5 % in the 3 previous months were r and omized between double-blind megestrol acetate 160 mg daily ( LMA ) , megestrol acetate 480 mg daily ( HMA ) , or placebo ( P ) . Weight , mid-arm circumference , triceps skinfold thickness ( TST ) , performance status ( Karnofsky index ) , and a quality -of-life status by seven linear analogic self- assessment scales were assessed before the start of treatment and at 4 , 8 , and 12 weeks thereafter . One hundred seven patients were assessable at 4 weeks , 79 at 8 weeks , and 64 at 12 weeks . Sixty-eight percent of patients treated with HMA increased their weights during their permanence on study , versus 37 % and 38 % of patients treated with P or LMA ( p < 0.03 ) . The mean weight gain after 12 weeks of treatment with HMA was 5.41 kg . A significant increase on TST was observed in the HMA group versus the LMA and P groups . There was no gain in performance status or quality of life in any group of treatment . The toxicity registered was mild . There were no thromboembolic events . This trial supports the efficacy of megestrol acetate at 480 mg/day in the treatment of cancer-related cachexia and anorexia , with mild toxicity . However , performance status and quality of life were not influenced by this treatment AIMS AND BACKGROUND The optimal treatment of cancer cachexia remains unknown . In this study , we compared the efficacy of three different treatment modalities in the management of cancer cachexia . METHODS Sixty-two assessable cachectic cancer patients were r and omized to one of the following three arms : 1 ) megesterol acetate ( MA ) plus meloxicam ( n = 23 ) ; 2 ) MA plus meloxicam plus oral eicosapentaenoic acid (EPA)-enriched nutritional supplement ( n = 21 ) ; or 3 ) meloxicam plus oral EPA-enriched nutritional supplement ( n = 18 ) . Treatment duration was 3 months . RESULTS The treatment arms were well balanced at baseline . The primary efficacy ( body weight and lean body mass ) and secondary efficacy ( body mass index , quality of life , and serum levels of IL-6 and TNF-α ) parameters improved after treatment in all three arms . There were no statistically significant differences between treatment groups in the mean percentage changes in all efficacy parameters from baseline to end of study . CONCLUSIONS MA plus meloxicam or EPA supplement plus meloxicam may be effective treatment options in the management of cancer cachexia . The combined use of these agents does not provide further advantages OBJECTIVES Malnutrition is a negative prognostic indicator in patients with cystic fibrosis ( CF ) and may accentuate pulmonary decline . We tested whether megestrol acetate would have beneficial effects on growth in patients with CF and pancreatic insufficiency . STUDY DESIGN We performed a r and omized , double-blind , placebo controlled study . All patients were taking replacement enzymes to compensate for pancreatic insufficiency . Patients ( n = 17 ) were r and omly assigned to receive either megestrol acetate or placebo . RESULTS The treatment group had a significant increase in weight-for-age z scores compared with placebo and reached 100 % of their ideal body weight within 3 months of initiating therapy . Weight gain included both fat and fat-free mass . Improved pulmonary function ( forced vital capacity and forced expiratory volume in 1 second ) was noted in the treatment group compared with placebo ( P < .04 ) . Reversible adrenal suppression was observed in the majority of patients who received megestrol acetate . CONCLUSIONS Short-term use of megestrol acetate results in significant weight gain and improved pulmonary function in malnourished subjects with CF . Our study provides a controlled basis for this intervention , identifies important side effects , and provides the foundation for multiyear , longitudinal trials in a larger number of patients with CF To assess the effect of megestrol acetate ( MA ) on the appetite and weight of cancer patients with nonhormone-dependent tumors , a double-blind , placebo-controlled trial was design ed . One hundred fifty patients were included : 76 were given MA ( 240 mg/day orally ) for at least 2 months , and 74 were given placebo ( P ) . Body weight , subjective sense of appetite ( SSA ) evaluated by an analogic linear visual scale scored from 1 to 10 , and performance status ( PS ) were measured before therapy and monthly thereafter . No differences in body weight before and after treatment could be found in any group . However , 32 % of the patients in the MA group ( 95 % confidence interval : 20.1–44.6 % ) gained 2 or more kilograms ( P < 0.001 ) . This group also showed an improvement in SSA ( P < 0.01 ) : an increase 2 points appeared in 57.5 % of patients ( 95 % confidence interval 44.6–69.4 % ) . There was no significant difference in PS for the treatment groups before or after therapy . The percentage of reported adverse events did not differ significantly from one treatment group to the next . We conclude that therapy with MA at a dose of 240 mg/day improved SSA and was associated with moderate weight gain in patients with hormone-insensitive malignancies BACKGROUND Weight loss among older patients is a severe problem , associated with an increased incidence of infections , decubiti , and death . Megestrol acetate ( MA ) causes weight gain in cachectic cancer and AIDS patients , but its effects in older cachectic patients are unknown . OBJECTIVE To compare the effects of MA oral suspension ( O.S. ) , 800 mg/day , versus placebo on weight in geriatric nursing home patients with weight loss or low body weight . DESIGN Twelve-week , r and omized , double-blind , placebo-controlled trial with a 13-week follow-up period . SETTING Veterans Administration Medical Center ( VMAC ) nursing home . PATIENTS Nursing home patients with weight loss of > or = 5 % of usual body weight over the past 3 months , or body weight 20 % below their ideal body weight . INTERVENTIONS Patients were r and omly assigned to receive placebo or MA 800 mg/day for 12 weeks and were then followed for 13 weeks off treatment . MEASUREMENTS Primary outcome was measured by weight and appetite change . Secondary outcome measures included sense of well-being , enjoyment of life , change in depression scale , laboratory nutrition parameters , energy intake counts , body composition , and adverse events . RESULTS At 12 weeks there were no significant differences in weight gain between treatment groups , whereas MA-treated patients reported significantly greater improvement in appetite , enjoyment of life , and well-being . Body composition was not statistically different between the two groups . At Week 25 ( 3 months after treatment ) , 61.9 % of MA-treated patients had gained > or = 1.82 kg ( 4 lbs ) compared to 21.7 % of placebo patients . CONCLUSIONS In geriatric patients with weight loss or low body weight MA improves appetite and well-being after 12 weeks of treatment . During the 3 months of MA treatment , there was no statistically significant weight gain ( > or = 4 lbs ) . Three months after treatment , weight gain ( > or = 4 lbs ) was significantly increased in MA-treated patients Reduced food intake is probably the major cause of continuing weight loss in cancer patients . Therefore , agents which stimulate food intake may be of significant benefit to such patients . To examine this , a r and omized double-blind placebo controlled study of megestrol acetate was carried out . 38 gastrointestinal cancer patients with weight loss ( 8 - 43 % of pre-illness stable weight ) were entered into the study . 26 were evaluable at 6 weeks and 21 at 12 weeks . Clinical details , serum biochemistry and haematology were examined at 6 and 12 weeks and total body water , total body potassium at 12 weeks after the baseline assessment . There was no significant weight change in either group over the 6 or 12 weeks . Furthermore , there was no significant difference in total body water , total body potassium , blood biochemistry or haematology between the groups over the study period . It does not appear that megestrol acetate at a dose of 480 mg/day results in weight gain in advanced gastrointestinal cancer patients with weight loss PURPOSE To determine whether dronabinol administered alone or with megestrol acetate was more , less , or equal in efficacy to single-agent megestrol acetate for palliating cancer-associated anorexia . 
    Output:
    
Thus , we can not reach a conclusion for an optimal dose of MA