NcXHF

ASSESSMENT AND TREATMENT OF CACS
fıts in reducing elevated resting energy expenditure and attenuation
of weight loss and also improvements in survival
(p 0.03). Although NSAIDs have been combined with
other agents and have demonstrated improvement in some
clinical outcomes, a systematic review concluded that the risk
of side effects and insuffıcient evidence suggest NSAIDs
should be restricted to clinical trials. 85
CONCLUSION
Because the causes of muscle wasting and poor caloric intake
in patients with CACS are multifactorial, a comprehensive
multidimensional approach using pharmacologic and nonpharmacologic
interventions is most likely to be effective in
reversing or stabilizing weight loss and muscle wasting. Ideally,
treatment should be individualized, taking into account
the patient’s overall condition, the principal mechanisms of
their weight loss, and their goals of care. New anticachexia
agents have shown promise in preclinical and early-phase
studies, but their effıcacy and safety need to be confırmed in
larger phase III RCTs. Clearly there is an unmet need for an
effective pharmacologic agent, and even though we now have
several promising candidates, any specifıc anticachexia intervention
would still need to be incorporated into a multimodality
approach.
Disclosures of Potential Conflicts of Interest
Relationships are considered self-held and compensated unless otherwise noted. Relationships marked “L” indicate leadership positions. Relationships marked “I” are those held by an immediate
family member; those marked “B” are held by the author and an immediate family member. Institutional relationships are marked “Inst.” Relationships marked “U” are uncompensated.
Employment: None. Leadership Position: None. Stock or Other Ownership Interests: None. Honoraria: None. Consulting or Advisory Role: Egidio Del
Fabbro, Helsinn Therapeutics. Speakers’ Bureau: None. Research Funding: Egidio Del Fabbro, Helsinn Therapeutics, Novartis. Patents, Royalties, or
Other Intellectual Property: None. Expert Testimony: None. Travel, Accommodations, Expenses: None. Other Relationships: None.
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