Anamorelin improves renal function markers, reduces deterioration risk in cancer cachexia patients
Background
Patients with cancer cachexia face a debilitating syndrome characterized by significant weight loss, muscle atrophy, and fat loss, affecting over 50% of terminal cancer patients. This condition not only severely impacts quality of life but can also compromise organ function due to systemic inflammation and metabolic derangements. While Anamorelin, a ghrelin mimetic, is established for its anabolic effects in cachexia, its specific impact on renal function has been less understood. This study addresses a critical gap by investigating whether Anamorelin offers renoprotective benefits in this vulnerable patient population.
Study Design
This retrospective, single-center, observational cohort study reviewed electronic medical records of patients diagnosed with cancer cachexia. Renal function parameters, including blood urea nitrogen (BUN), serum creatinine, and estimated glomerular filtration rate (eGFR), were compared between patients treated with Anamorelin and those not receiving ANAM. Propensity score matching was applied to adjust for baseline imbalances in patient characteristics. Renal deterioration was precisely defined as a ≥ 10% increase in BUN or serum creatinine, or a ≥ 10% decrease in eGFR. Cox proportional hazards models were then used to analyze the risk of deterioration for each renal marker.
Results
After propensity score matching, Anamorelin treatment was associated with significantly greater improvements in serum creatinine and eGFR over an 8-week period compared with non-ANAM treatment. Multivariable Cox regression analyses further demonstrated that Anamorelin use was independently associated with a reduction in the risk of a ≥ 10% increase in serum creatinine and a ≥ 10% decrease in eGFR. These findings suggest a direct protective effect on kidney function. Longitudinal analyses revealed that these improvements in renal function markers were most pronounced in the early phase after initiation of Anamorelin, followed by a gradual return toward baseline levels. This indicates a transient but significant positive impact.
Anamorelin treatment was associated with improvements in renal function markers and a lower risk of renal function deterioration in patients with cancer cachexia.
Key Findings
- Anamorelin treatment significantly improved serum creatinine and eGFR over an 8-week period.
- Anamorelin use independently reduced the risk of ≥ 10% increase in serum creatinine.
- Anamorelin use independently reduced the risk of ≥ 10% decrease in eGFR.
- Renal function marker improvements were observed early after Anamorelin initiation, then returned toward baseline.
Why It Matters
These findings suggest that Anamorelin may offer a dual benefit for patients with cancer cachexia, extending beyond its established role in improving appetite and body weight to potentially include renoprotective effects. This is particularly significant given that cancer and its treatments often compromise renal function, adding another layer of complexity to patient care. Clinicians might consider Anamorelin earlier or more broadly in cachectic patients who also have existing or anticipated renal concerns, potentially improving overall patient outcomes. While the improvements were transient, the reduction in deterioration risk highlights a novel aspect of this ghrelin mimetic, warranting further investigation into optimal dosing and duration for sustained renal benefits.
anamorelin
cancer-cachexia
renal-function
ghrelin-mimetic
observational-study
egfr