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| |  ADA: Maintaining Weight May Improve Survival, Quality of Life For HIV And Cancer Patients DENVER, CO -- October 16, 2000 -- Weight loss and HIV "wasting" have a direct impact on survival in cancer and in HIV/AIDS patients. Data supporting these findings, as well as methods for early intervention to prevent weight loss, were discussed here at a symposium, "Evidence-Based Management of Disease-Related Weight Loss," at the American Dietetic Association (ADA) Annual Meeting. "It is well-established that anorexia and cachexia -- weight loss in patients with chronic illness -- are directly associated with survival rates in patients with HIV infection and cancer," said Alvan Fisher, MD, Medical Director of the Coastal Medical/Reservoir in Providence, Rhode Island and Associate Director of the Brown University AIDS Program. "These conditions affect up to 87 percent of patients with malignant disease. They are involved in 80 percent of all cancer deaths. Cachexia is the cause of death in 22 percent of all cancer patients." Dr. Fisher presented study data on the prevalence of wasting -- the unintentional loss of at least 10 percent of normal weight -- in HIV/AIDS patients. In a recent study of HIV patients taking highly active antiretroviral therapy, 42 percent experienced clinical wasting. "With so many HIV/AIDS and cancer patients experiencing weight-loss, it is critical that care providers regularly monitor the nutritional status of their patients. Because weight loss can be a sign that a patient's overall condition is deteriorating, we need to identify early-on any appetite and weight loss before they become clinically significant -- particularly in patients taking chemotherapy and antiretroviral therapy," said Dr. Fisher. When anorexia/cachexia or wasting is diagnosed, early implementation of clinical approaches to managing malnutrition is recommended. Effective interventions for managing malnutrition include patient counseling, dietary supplementation, prophylaxis, exercise and drug therapy. Combinations of these interventions can improve survival and have an important impact on patient quality-of-life. Anabolic agents and appetite stimulants are two common categories of pharmacologic agents administered to treat wasting and weight loss in people with cancer and HIV/AIDS. Anabolic agents increase muscle mass. Appetite stimulants, such as Marinol® (dronabinol) and Megace® (megestrol acetate) help patients to increase appetite - which helps to maintain weight and ensure that patients get the nutrients needed to stay healthy. Dr. Fisher discussed long-term results of a study examining the appetite stimulation effect of Marinol versus placebo in 94 HIV/AIDS patients. Results showed that patients taking Marinol had a significant increase in appetite for up to 12 months. In a study evaluating Marinol in cancer patients, 13 of 18 patients reported improved appetite and eight of nine had increased caloric intake. "Administering an appetite stimulant, such as Marinol, not only helps patients to maintain a healthy appetite, it also may alleviate nausea and vomiting associated with chemotherapy and antiretroviral therapy," commented Dr. Fisher. Marinol is marketed by Roxane Laboratories and co-promoted with Unimed Pharmaceuticals, Inc. Marinol was first introduced onto the market by Roxane in 1986 for the treatment of cancer chemotherapy induced nausea and vomiting that is unresponsive to traditional medications. In 1992, the FDA approved a supplemental new drug application for Marinol for the treatment of appetite loss or anorexia associated with weight loss in AIDS patients. Marinol is generally well-tolerated with side effects usually being mild and reversed by a lowering of the drug's dose. The most common side effects involve the central nervous system and include sleepiness, dizziness and euphoria (or giddiness).
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