Dear Sir,
We read with interest the Letter to the Editor [Citation1] referred to our article on the novel therapies for cachexia and sarcopenia [Citation2]. In particular, the author of the letter highlighted the potential clinical relevance of novel anti-catabolic neurohormonal therapies to improve muscle mass during diseases [Citation1]. The majority of clinical data now available on these treatments come from ongoing trials in selected cancer patients [Citation3], particularly focusing on the efficacy of different molecules, including imidapril [Citation3] and espindolol [Citation4,Citation5]. In addition to these drugs, trimetazidine [Citation6] has been recently tested in experimental models in association with exercise, which appears as an essential strategy, combined with pharmacological therapy, to improve muscle compartment. However, most of the clinical data available, which have been summarized by the authors of the letter [Citation1], appear preliminary in terms of number of participants enrolled, type of disease considered, and, more importantly, in terms of long-term safety. In addition, besides the possible positive effects on muscle mass and function, we expect to see data on stronger outcomes (i.e. mortality) by studies with longer follow-up, aimed at ascertaining both efficacy and safety, before translating these results into clinical practice.
In conclusion, considering the negative clinical impact of sarcopenia and cachexia, we believe that any novel options should be considered by physicians and researchers to improve patients’ survival and quality of life.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Additional information
Funding
References
- Coats AJS. Cachexia therapies – the need to take a broader look. Expert Opin Biol Ther. 2017:1–2. doi: 10.1080/14712598.2017.1388600.
- Molfino A, Amabile MI, Rossi Fanelli F, et al. Novel therapeutic options for cachexia and sarcopenia. Expert Opin Biol Ther. 2016;16:1239–1244.
- Ark plans second Phase III study of vitor in cancer cachexia after mixed results. [cited 2017 Sep 26]. Available from: http://www.apmhealtheurope.com/print_story.php?numero=L1135
- Stewart Coats AJ, Ho GF, Prabhash K, et al. Espindolol for the treatment and prevention of cachexia in patients with stage III/IV non-small cell lung cancer or colorectal cancer: a randomized, double-blind, placebo-controlled, international multicentre phase II study (the ACT-ONE trial). J Cachexia Sarcopenia Muscle. 2016;7:355–365.
- Lainscak M, Laviano A. ACT-ONE - ACTION at last on cancer cachexia by adapting a novel action beta-blocker. J Cachexia Sarcopenia Muscle. 2016;7:400–402.
- Ferraro E, Pin F, Gorini S, et al. Improvement of skeletal muscle performance in ageing by the metabolic modulator trimetazidine. J Cachexia Sarcopenia Muscle. 2016;7:449–457.