{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:11:42Z","timestamp":1784625102185,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cancer cachexia (CC) is a multifactorial syndrome driven by inflammation, defined by ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support. CC leads to progressive functional impairment, with its clinical management complicated and limited therapeutic options available. The objective of this review was to assess the efficacy and safety of non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs) on patient\u2010centred outcomes in patients with CC. In 2013, two systematic reviews concluded that there was insufficient evidence to recommend NSAIDs for clinical management of CC outside of clinical trials. However, clinical trials of multi\u2010component CC interventions have included NSAIDs as an intervention component, so an up\u2010to\u2010date assessment of the evidence for NSAIDs in the treatment of CC is warranted. Four databases (MEDLINE, EMBASE, CENTRAL and CINAHL) and three trial registers (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>, WHO ICTRP and ISRCTN) were searched on 16 December 2022. Randomized controlled trials (RCTs) comparing any NSAID (any dose or duration) with a control arm, in adult patients with CC, reporting measures of body weight, body composition, nutrition impact symptoms, inflammation, physical function or fatigue, were eligible for inclusion. Primary outcomes (determined with patient involvement) were survival, changes in muscle strength, body composition, body weight and quality of life. Included studies were assessed for risk of bias using the Revised Cochrane risk\u2010of\u2010bias tool for randomized trials. Five studies were included, which investigated Indomethacin (<jats:italic>n<\/jats:italic>\u00a0=\u00a01), Ibuprofen (<jats:italic>n<\/jats:italic>\u00a0=\u00a01) and Celecoxib (<jats:italic>n<\/jats:italic>\u00a0=\u00a03). Four studies were judged to be at high risk of bias for all outcomes, with one study raising concerns for most outcomes. Considerable clinical and methodological heterogeneity amongst the studies meant that meta\u2010analysis was not appropriate. There was insufficient evidence to determine whether Indomethacin or Ibuprofen is effective or safe for use in patients with CC; RCTs with lower risk of bias are needed. Celecoxib studies indicated it was safe for use in this population at the doses tested (200\u2013400\u00a0mg\/day) but found contrasting results regarding efficacy, potentially reflecting heterogeneity amongst the studies. There is inadequate evidence to recommend any NSAID for CC. While current clinical trials for CC treatments are shifting towards multi\u2010component interventions, further research to determine the efficacy and safety of NSAIDs alone is necessary if they are to be included in such multi\u2010component interventions. Furthermore, the lack of data on patient\u2010determined primary outcomes in this review highlights the need for patient involvement in clinical trials for CC.<\/jats:p>","DOI":"10.1002\/jcsm.13327","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T10:56:16Z","timestamp":1695725776000},"page":"2473-2497","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Non\u2010steroidal anti\u2010inflammatory drugs for treatment of cancer cachexia: A systematic review"],"prefix":"10.1002","volume":"14","author":[{"given":"Megan","family":"Bowers","sequence":"first","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy &amp; Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery &amp; Palliative Care King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Cucchiaro","sequence":"additional","affiliation":[{"name":"Division of Medicine, Faculty of Medical Sciences University College London  London UK"},{"name":"University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Reid","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Queen's University Belfast, Medical Biology Center  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Slee","sequence":"additional","affiliation":[{"name":"Division of Medicine, Faculty of Medical Sciences University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70218-7"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S261585"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002966511500419X"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1517\/14712598.2010.503773"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3829"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00611"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2021.100092"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/13543784.2019.1646727"},{"key":"e_1_2_9_10_1","unstructured":"British National Formulary National Institute of Health and Care Excellence.Non\u2010steroidal anti\u2010inflammatory drugs.https:\/\/bnf.nice.org.uk\/treatment-summaries\/non-steroidal-anti-inflammatory-drugs\/. 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