Fifteen studies were included (n=139). Three studies were randomised and double-blind. Ten did not use a control. The sample sizes ranged from one to 18.
The median number of measures included in the studies was 4 (range 1 to 7). Levels of evidence ranged from levels II to V.
Megesterol acetate: Two randomised double-blind placebo-controlled studies reported statistically significant improvements in weight and lung function. Four found improvement in body composition, two of which were statistically significant. A statistically significant improvement in oral energy and protein intake was reported in one study.
Mirtazapine and dronabinol: Two non-randomised trials reported statistically significant weight gain, as did a cyproheptadine study.
Adverse effects: Adverse effects for megesterol acetate included adrenal suppression, abnormalities of glycaemic control, mood changes and testicular failure. Mood changes were reported with cyproheptadine and dronabinol.