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The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 6 2832-2836
Copyright © 2004 by The Endocrine Society

Ghrelin Increases Energy Intake in Cancer Patients with Impaired Appetite: Acute, Randomized, Placebo-Controlled Trial

Nicola M. Neary, Caroline J. Small, Alison M. Wren, Jennifer L. Lee, Maralyn R. Druce, Carlo Palmieri, Gary S. Frost, Mohammad A. Ghatei, R. Charles Coombes and Stephen R. Bloom

Department of Metabolic Medicine (N.M.N., C.J.S., A.M.W., M.R.D., M.A.G., S.R.B.), Nutrition and Dietetic Research Group (J.L.L., G.S.F.), and Department of Cancer Medicine (C.P., R.C.C.), Faculty of Medicine, Imperial College London, London, United Kingdom W12 0NN

Address all correspondence and requests for reprints to: Dr. S. R. Bloom, Department of Metabolic Medicine, Faculty of Medicine, Imperial College London, Hammersmith Campus, Du Cane Road, London, United Kingdom W12 ONN. E-mail: s.bloom{at}imperial.ac.uk.

There is a pressing need for more effective appetite-stimulatory therapies for many patient groups including those with cancer. We have previously demonstrated that the gastric hormone ghrelin potently enhances appetite in healthy volunteers. Here, we performed an acute, randomized, placebo-controlled, cross-over clinical trial to determine whether ghrelin stimulates appetite in cancer patients with anorexia. Seven cancer patients who reported loss of appetite were recruited from oncology clinics at Charing Cross Hospital. The main outcome measures were energy intake from a buffet meal during ghrelin or saline infusion and meal appreciation as assessed by visual analog scale. A marked increase in energy intake (31 ± 7%; P = 0.005) was observed with ghrelin infusion compared with saline control, and every patient ate more. The meal appreciation score was greater by 28 ± 8% (P = 0.02) with ghrelin treatment. No side effects were observed. The stimulatory effects of ghrelin on food intake and meal appreciation seen in this preliminary study suggest that ghrelin could be an effective treatment for cancer anorexia and possibly for appetite loss in other patient groups.

This work was supported by Medical Research Council Program Grant G7811974 (to S.R.B., M.A.G., and C.J.S.). N.M.N., A.M.W., and M.R.D. are Wellcome Trust Clinical Research Training Fellows. R.C.C. and C.P. are supported by Cancer Research (UK).

Abbreviation: CI, Confidence interval.




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