- The Ana-IGF-1 low group showed significantly higher IL-6 levels at baseline and significantly shorter overall survival compared to the Ana-IGF-1 high group

- Adverse events were comparable between the 2 groups (any grade: 100% vs 100%; grade ≥3: 88.9% vs 90.0%)

When the anamorelin group was divided into 2 groups by the median serum IGF-1 level after 1 week (Ana-IGF-1 high and Ana-IGF-1 low groups), the SMI in the latter group showed a decreased tendency (p = 0.14).

- Serum IGF-1 levels in the anamorelin-treated group were higher after 1 week

- Changes in IGF-1 and SMI positively correlated in the anamorelin group (R = 0.61)

Patients with metastatic urothelial carcinoma were randomized to anamorelin (100 mg orally) (Ana; n = 20) or control (systemic chemotherapy only) (n = 18) groups for 12 weeks.

Gemcitabine + cisplatin or gemcitabine + carboplatin therapy was performed as a systemic chemotherapy.

- Results were overall lacking in regards to resistance or aerobic exercise and IntraMAT (due to the low number of studies).

- When concurrent exercise was followed, no statistically significant changes were observed with or without a hypocaloric diet on thigh InterMAT and IntraMAT.

- Under non-hypocaloric conditions there were consistently no alterations of InterMAT and intramuscular fat (IntraMAT) irrespective of muscle tissue.

Based on 19 RCTs:
- Resistance and aerobic exercise alongside a hypocaloric diet displayed inconsistent results in reducing thigh intermuscular fat (InterMAT).

Current evidence does not support NMN and NR supplementation for preserving muscle mass and function in adults with mean age of 60 years and above. Future research should explore various supplementation dosages, NAD+ baseline deficiency, and combined interventions