{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:16:05Z","timestamp":1780492565966,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["CGCATF\u20102021\/100022"],"award-info":[{"award-number":["CGCATF\u20102021\/100022"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1 OT2 CA278685\u201001"],"award-info":[{"award-number":["1 OT2 CA278685\u201001"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["NIH K08 CA230318"],"award-info":[{"award-number":["NIH K08 CA230318"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["NIH P30 CA008748"],"award-info":[{"award-number":["NIH P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","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":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The cancer\u2010anorexia\u2010cachexia syndrome (CACS) is a common and debilitating wasting disorder characterized by loss of skeletal muscle and worse morbidity and mortality. In pre\u2010clinical studies, CACS is associated with loss of peroxisome proliferator\u2010activated receptor alpha (PPAR\u2010\u03b1) dependent ketone production in the liver. Fibrates are PPAR\u2010\u03b1 agonists that are commonly used to treat dyslipidemia. Treating mice with fibrates was found to prevent skeletal muscle loss. We examine whether patients with cancer treated with PPAR\u2010\u03b1 agonists experience less CACS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study of patients (<jats:italic>N<\/jats:italic>\u2009=\u20096922) at Memorial Sloan Kettering Cancer Center who were diagnosed with non\u2010small cell lung cancer (NSCLC) between 2002 and 2017 and were incidentally prescribed fenofibrate or gemfibrozil at the time of diagnosis. These patients were compared to a propensity score\u2010matched control set who were not taking either drug. The primary outcome included a composite outcome of CACS, which included significant weight loss before or after the time of diagnosis. Secondary outcomes included change in cross\u2010sectional skeletal muscle area over time as measured in serial CT imaging studies and overall survival. Descriptive statistics, Kaplan\u2013Meier analysis and multivariable logistic regression were performed to compare outcomes between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among patients with NSCLC, 149 were taking fenofibrate or gemfibrozil at the time of diagnosis. A 2:1 propensity score\u2010matched cohort of 298 patients was created that was well\u2010matched with regard to baseline characteristics. Regarding the primary composite outcome, there was no significant difference in the prevalence of CACS between those taking fibrates and propensity\u2010matched controls (49.7 vs. 46.6%). When skeletal muscle mass was measured directly using cross\u2010sectional imaging, patients on fibrates were found to have lost significantly less muscle area over time (\u22123.3 vs.\u22124.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.03). There was no difference in overall survival between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with NSCLC taking fibrates at the time of diagnosis lost less muscle area over time. In a secondary analysis, this change was not associated with a change in overall survival, though this study was likely underpowered for this analysis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.70016","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T16:39:22Z","timestamp":1755707962000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reduced Muscle Loss in Patients With NSCLC Taking Fibrates: Findings From a Retrospective Observational Study"],"prefix":"10.1002","volume":"16","author":[{"given":"Rahmi","family":"Elahjji","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahj","family":"Blow","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Grover","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice\u00a0A.","family":"Hurd","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard\u00a0F.","family":"Dunne","sequence":"additional","affiliation":[{"name":"University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bette\u00a0J.","family":"Caan","sequence":"additional","affiliation":[{"name":"Kaiser Permanente  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth\u00a0M.","family":"Cespedes\u00a0Feliciano","sequence":"additional","affiliation":[{"name":"Kaiser Permanente  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew\u00a0J.","family":"Plodkowski","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James\u00a0H.","family":"Flory","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0784-9248","authenticated-orcid":false,"given":"Marcus\u00a0D.","family":"Goncalves","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70218-7"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.6-2-140"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21442"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2010.28608C"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.105"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-010-0972-0"},{"key":"e_1_2_7_8_1","first-page":"E743","article-title":"Fenofibrate Prevents Skeletal Muscle Loss in Mice With Lung Cancer","volume":"115","author":"Goncalves M. 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