{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:39:36Z","timestamp":1790959176917,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","award":["62676"],"award-info":[{"award-number":["62676"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is inconsistent evidence relating to the effects of megestrol acetate (MA) supplementation on cancer patients suffering from anorexia\u2013cachexia syndrome. This review aimed to examine the dose\u2013response effect of MA supplementation in patients with cancer\u2010associated anorexia\/cachexia. Relevant keywords were searched in PubMed, Scopus and ISI Web of Science from inception to June 2023 for randomized controlled trials (RCTs) examining the effect of MA on pathologies in patients with cancer\u2010associated cachexia. Our primary outcomes were changes in body weight and appetite. However, fatigue and quality of life were secondary outcomes. The mean difference (MD) and 95% confidence interval (95% CI) were estimated using the random\u2010effects method. Thirteen trials comprising 1229 participants (mean age 60\u00a0years) were identified. The results of our highest versus lowest analysis revealed that MA supplementation was not associated with any increase in body weight (MD: 0.64\u00a0kg, 95% CI [\u22120.11, 1.38], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.093, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a069.1%; GRADE\u00a0=\u00a0very low certainty). Twelve trials, including 14 effect sizes derived from 1369 patients (intervention\u00a0=\u00a0689, control\u00a0=\u00a0680), provided data on the effect of MA on body weight. Subgroup analyses showed a significant increase in body weight following short\u2010term intervention (\u22648\u00a0weeks) and a combination of radiation\/chemotherapy as concurrent treatment. A linear dose\u2013response meta\u2010analysis indicated that each 200\u00a0mg\/day increment in MA consumption had a significant increase in weight gain (MD: 0.44; 95% CI [0.13, 0.74], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a097.1%); however, the magnitude of the effect was small. MA administration significantly affected the quality of life based on pooled effect sizes (MD: 1.15, 95% CI [0.76, 1.54], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%; <jats:italic>n<\/jats:italic>\u00a0=\u00a02 RCTs including 176 patients; GRADE\u00a0=\u00a0very low certainty). However, no significant effect of MA supplementation was observed on appetite (MD: 0.29, 95% CI [\u22120.05, 0.64], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.096, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a018.3%; <jats:italic>n<\/jats:italic>\u00a0=\u00a03 RCTs including 163 patients; GRADE\u00a0=\u00a0very low certainty) and fatigue (MD: 0.14, 95% CI [\u22120.09, 0.36], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.236, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%; <jats:italic>n<\/jats:italic>\u00a0=\u00a02 RCTs including 300 patients; GRADE\u00a0=\u00a0very low certainty). With very low certainty of the evidence, MA supplementation may not lead to a significantly increased weight gain and other outcomes.<\/jats:p>","DOI":"10.1002\/jcsm.13500","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T06:23:42Z","timestamp":1718951022000},"page":"1254-1263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Dose\u2010dependent effect of megestrol acetate supplementation in cancer patients with anorexia\u2013cachexia syndrome: A meta\u2010analysis"],"prefix":"10.1002","volume":"15","author":[{"given":"Sepide","family":"Talebi","sequence":"first","affiliation":[{"name":"Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences  Tehran Iran"},{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences  Tehran 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