- Email: [email protected]
In reply: Treatment of cachexia: An overview of recent developments
International Journal of Cardiology 201 (2015) 424
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Invited letter to the Editor
In reply: Treatment of cachexia: An overview of recent developments Stephan von Haehling a,b,⁎, Stefan D. Anker a a b
Division of Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany
a r t i c l e
i n f o
Article history: Received 17 July 2015 Accepted 1 August 2015 Available online 5 August 2015
To the Editor In reply: We thank Molfino et al. [1] for their very positive comments with regard to our overview of recent advances in the treatment of cachexia [2]. We are grateful for their additional mechanistic insight into the potential role of L-carnitine as a therapy in these patients. As it is difficult to discuss all available data on a specific therapy, we decided to restrict our review to clinical intervention trials that had been published over the last 2 years with the primary purpose of treating cachexia. Only two trials were aimed at treating cachexia not associated with cancer [3,4]. Studies of L-carnitine discussed in our article were all performed in patients with cancer [5,6]. As highlighted by the Molfino and colleagues, it is important to draw additional attention to cardiac cachexia, in which only few intervention trials have been published even though patients lose not only skeletal muscle [7] but also fat [8], and only the combination of the two types of tissue wasting finally yields cachexia [9–11]. The road from muscle wasting to cachexia is frequently associated with physical frailty [12]. Therefore, we welcome therapeutic approaches that increase muscle mass and improve muscle wasting – such as L-carnitine – but also those aimed at increasing fat mass.
⁎ Corresponding author at: Division of Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medicine Centre Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany. E-mail address: [email protected] (S. von Haehling).
http://dx.doi.org/10.1016/j.ijcard.2015.08.012 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
References [1] A. Molfino, M.I. Amabile, M. Monti, F. Rossi Fanelli, M. Muscaritoli, Carnitine for the treatment of cachexia: lights and shadows, Int. J. Cardiol. (2015) (ADD DATA). [2] S. von Haehling, S.D. Anker, Treatment of cachexia: an overview of recent developments, Int. J. Cardiol. 184 (2015) 736–742. [3] M. Rattanasompattikul, M.Z. Molnar, M.L. Lee, R. Dukkipati, R. Bross, J. Jing, Y. Kim, A.C. Voss, D. Benner, U. Feroze, I.C. MacDougall, J.A. Tayek, K.C. Norris, J.D. Kopple, M. Unruh, C.P. Kovesdy, K. Kalantar-Zadeh, Anti-inflammatory and anti-oxidative nutrition in hypoalbuminemic dialysis patients (AIONID) study: results of the pilot-feasibility, double-blind, randomized, placebo-controlled trial, J. Cachex. Sarcopenia Muscle 4 (2013) 247–257. [4] K. Miki, R. Maekura, N. Nagaya, M. Nakazato, H. Kimura, S. Murakami, S. Ohnishi, T. Hiraga, M. Miki, S. Kitada, K. Yoshimura, Y. Tateishi, Y. Arimura, N. Matsumoto, M. Yoshikawa, K. Yamahara, K. Kangawa, Ghrelin treatment of cachectic patients with chronic obstructive pulmonary disease: a multicenter, randomized, double-blind, placebo-controlled trial, PLoS ONE 7 (2012) e35708. [5] C. Madeddu, M. Dessì, F. Panzone, R. Serpe, G. Antoni, M.C. Cau, L. Montaldo, Q. Mela, M. Mura, G. Astara, F.M. Tanca, A. Macciò, G. Mantovani, Randomized phase III clinical trial of a combined treatment with carnitine + celecoxib ± megestrol acetate for patients with cancer-related anorexia/cachexia syndrome, Clin. Nutr. 31 (2012) 176–182. [6] M. Kraft, K. Kraft, S. Gärtner, J. Mayerle, P. Simon, E. Weber, K. Schütte, J. Stieler, H. Koula-Jenik, P. Holzhauer, U. Gröber, G. Engel, C. Müller, Y.S. Feng, A. Aghdassi, C. Nitsche, P. Malfertheiner, M. Patrzyk, T. Kohlmann, M.M. Lerch, L-Carnitinesupplementation in advanced pancreatic cancer (CARPAN) — a randomized multicentre trial, Nutr. J. 11 (2012) 52. [7] S. Fülster, M. Tacke, A. Sandek, N. Ebner, C. Tschöpe, W. Doehner, S.D. Anker, S. von Haehling, Muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF), Eur. Heart J. 34 (2013) 512–519. [8] G. Loncar, S. Fülster, S. von Haehling, V. Popovic, Metabolism and the heart: an overview of muscle, fat, and bone metabolism in heart failure, Int. J. Cardiol. 162 (2013) 77–85. [9] J.E. Morley, S.D. Anker, S. von Haehling, Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014, J. Cachex. Sarcopenia Muscle 5 (2014) 253–259. [10] S. von Haehling, L. Steinbeck, W. Doehner, J. Springer, S.D. Anker, Muscle wasting in heart failure: an overview, Int. J. Biochem. Cell Biol. 45 (2013) 2257–2265. [11] S. von Haehling, S.D. Anker, Prevalence, incidence and clinical impact of cachexia: facts and numbers-update 2014, J. Cachex. Sarcopenia Muscle 5 (2014) 261–263. [12] J.E. Morley, S. von Haehling, S.D. Anker, B. Vellas, From sarcopenia to frailty: a road less traveled, J. Cachex. Sarcopenia Muscle 5 (2014) 5–8.
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Invited letter to the Editor
In reply: Treatment of cachexia: An overview of recent developments Stephan von Haehling a,b,⁎, Stefan D. Anker a a b
Division of Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen, Göttingen, Germany Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany
a r t i c l e
i n f o
Article history: Received 17 July 2015 Accepted 1 August 2015 Available online 5 August 2015
To the Editor In reply: We thank Molfino et al. [1] for their very positive comments with regard to our overview of recent advances in the treatment of cachexia [2]. We are grateful for their additional mechanistic insight into the potential role of L-carnitine as a therapy in these patients. As it is difficult to discuss all available data on a specific therapy, we decided to restrict our review to clinical intervention trials that had been published over the last 2 years with the primary purpose of treating cachexia. Only two trials were aimed at treating cachexia not associated with cancer [3,4]. Studies of L-carnitine discussed in our article were all performed in patients with cancer [5,6]. As highlighted by the Molfino and colleagues, it is important to draw additional attention to cardiac cachexia, in which only few intervention trials have been published even though patients lose not only skeletal muscle [7] but also fat [8], and only the combination of the two types of tissue wasting finally yields cachexia [9–11]. The road from muscle wasting to cachexia is frequently associated with physical frailty [12]. Therefore, we welcome therapeutic approaches that increase muscle mass and improve muscle wasting – such as L-carnitine – but also those aimed at increasing fat mass.
⁎ Corresponding author at: Division of Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medicine Centre Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany. E-mail address: [email protected] (S. von Haehling).
http://dx.doi.org/10.1016/j.ijcard.2015.08.012 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
References [1] A. Molfino, M.I. Amabile, M. Monti, F. Rossi Fanelli, M. Muscaritoli, Carnitine for the treatment of cachexia: lights and shadows, Int. J. Cardiol. (2015) (ADD DATA). [2] S. von Haehling, S.D. Anker, Treatment of cachexia: an overview of recent developments, Int. J. Cardiol. 184 (2015) 736–742. [3] M. Rattanasompattikul, M.Z. Molnar, M.L. Lee, R. Dukkipati, R. Bross, J. Jing, Y. Kim, A.C. Voss, D. Benner, U. Feroze, I.C. MacDougall, J.A. Tayek, K.C. Norris, J.D. Kopple, M. Unruh, C.P. Kovesdy, K. Kalantar-Zadeh, Anti-inflammatory and anti-oxidative nutrition in hypoalbuminemic dialysis patients (AIONID) study: results of the pilot-feasibility, double-blind, randomized, placebo-controlled trial, J. Cachex. Sarcopenia Muscle 4 (2013) 247–257. [4] K. Miki, R. Maekura, N. Nagaya, M. Nakazato, H. Kimura, S. Murakami, S. Ohnishi, T. Hiraga, M. Miki, S. Kitada, K. Yoshimura, Y. Tateishi, Y. Arimura, N. Matsumoto, M. Yoshikawa, K. Yamahara, K. Kangawa, Ghrelin treatment of cachectic patients with chronic obstructive pulmonary disease: a multicenter, randomized, double-blind, placebo-controlled trial, PLoS ONE 7 (2012) e35708. [5] C. Madeddu, M. Dessì, F. Panzone, R. Serpe, G. Antoni, M.C. Cau, L. Montaldo, Q. Mela, M. Mura, G. Astara, F.M. Tanca, A. Macciò, G. Mantovani, Randomized phase III clinical trial of a combined treatment with carnitine + celecoxib ± megestrol acetate for patients with cancer-related anorexia/cachexia syndrome, Clin. Nutr. 31 (2012) 176–182. [6] M. Kraft, K. Kraft, S. Gärtner, J. Mayerle, P. Simon, E. Weber, K. Schütte, J. Stieler, H. Koula-Jenik, P. Holzhauer, U. Gröber, G. Engel, C. Müller, Y.S. Feng, A. Aghdassi, C. Nitsche, P. Malfertheiner, M. Patrzyk, T. Kohlmann, M.M. Lerch, L-Carnitinesupplementation in advanced pancreatic cancer (CARPAN) — a randomized multicentre trial, Nutr. J. 11 (2012) 52. [7] S. Fülster, M. Tacke, A. Sandek, N. Ebner, C. Tschöpe, W. Doehner, S.D. Anker, S. von Haehling, Muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF), Eur. Heart J. 34 (2013) 512–519. [8] G. Loncar, S. Fülster, S. von Haehling, V. Popovic, Metabolism and the heart: an overview of muscle, fat, and bone metabolism in heart failure, Int. J. Cardiol. 162 (2013) 77–85. [9] J.E. Morley, S.D. Anker, S. von Haehling, Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014, J. Cachex. Sarcopenia Muscle 5 (2014) 253–259. [10] S. von Haehling, L. Steinbeck, W. Doehner, J. Springer, S.D. Anker, Muscle wasting in heart failure: an overview, Int. J. Biochem. Cell Biol. 45 (2013) 2257–2265. [11] S. von Haehling, S.D. Anker, Prevalence, incidence and clinical impact of cachexia: facts and numbers-update 2014, J. Cachex. Sarcopenia Muscle 5 (2014) 261–263. [12] J.E. Morley, S. von Haehling, S.D. Anker, B. Vellas, From sarcopenia to frailty: a road less traveled, J. Cachex. Sarcopenia Muscle 5 (2014) 5–8.