Juven

Juven is a medical food that is manufactured by Abbott Laboratories and used to provide nutritional support under the care of a physician in individuals with muscle wasting due to AIDS or cancer, to promote wound healing following surgery or injury, or when otherwise recommended by a medical professional.[1][2][3] It is a powdered nutritional supplement that contains 3 grams of calcium β-hydroxy β-methylbutyrate, 14 grams of L-arginine, and 14 grams of L-glutamine per two daily servings.[1]

Juven has been shown to increase lean body mass during clinical trials in individuals with AIDS and cancer, but not rheumatoid cachexia.[4][5][6] Clinical trials with Juven for AIDS have also demonstrated improvements in immune status, as measured by a reduced HIV viral load relative to controls and higher CD3+ and CD8+ cell counts.[note 1][4][6] The efficacy of Juven for the treatment of cancer cachexia was also examined in a phase 3 clinical trial which found a strong trend (i.e., p=.08) for an improvement in lean body mass relative to controls;[4][5][8] however, according to the authors of the trial itself and a systematic review that included it, the trial did not adequately test the ability of Juven to prevent or reverse the loss of lean body mass in individuals with cancer cachexia since the majority of participants did not complete the study.[4][8] Further research involving the treatment of cancer cachexia with Juven over a period of several months is required to adequately determine treatment efficacy.[4][5]

Notes
  1. Since all T cells are CD3+, a measure of CD3+ cells is used as a general estimate of total T cells.[7]

References
  1. "Product Information: Juven" (PDF). Abbott Nutrition. 7 May 2016. Retrieved 6 October 2022.
     • Administer orally or as a modular via feeding tube ...
     • Use under medical supervision.
     • Nutravigor® (CaHMB, calcium β-hydroxy-β-methylbutyrate) – a metabolite of leucine that regulates protein metabolism in muscle cells.4
     • Arginine – a conditionally essential amino acid5 that is a precursor of nitric oxide, which supports blood flow.6
     • Glutamine – a conditionally essential amino acid5 that stimulates fibroblastic collagen production7,8 and supports nitrogen metabolism.5,9
  2. Linn J (13 May 2013). "Proteins in Human Health and Performance". Iowa State University. Archived from the original on 27 August 2016. Retrieved 31 July 2016. HMB is currently marketed nationally by Abbott Laboratories as Revigor™, which is a component of Ensure® Muscle Health, and Juven®, which is a nutritional beverage that is clinically shown to promote healing after injury or surgery.
  3. Khamsi R (May 2013). "Rethinking the formula". Nat. Med. 19 (5): 525–529. doi:10.1038/nm0513-525. PMID 23652097. The questions about what defines a medical food will likely grow as the market does—and that market now extends far beyond PKU and other inherited metabolic disorders. Vitamax, for example, is a chewable tablet designed to meet the specific vitamin needs of people with cystic fibrosis; Vascazen, meanwhile, contains purified omega-3 fatty acids for people with cardiovascular disease; Abbott Nutrition's Juven provides nutrients to people with HIV or AIDS experiencing excessive weight loss due to disease; ...
  4. Molfino A, Gioia G, Rossi Fanelli F, Muscaritoli M (December 2013). "Beta-hydroxy-beta-methylbutyrate supplementation in health and disease: a systematic review of randomized trials". Amino Acids. 45 (6): 1273–1292. doi:10.1007/s00726-013-1592-z. PMID 24057808. S2CID 254079612. Interesting results were observed during cancer, notably, patients with advanced (stage IV) cancer receiving a HMB/ARG/GLN supplement gained 0.95 ± 0.66 kg of BM in 4 weeks and a change in body composition (FFM increase of 1.12 ± 0.68 kg). The FFM increase was maintained over the 24 weeks (May et al. 2002). Human immunodeficiency virus (HIV)-infected patients gained 3.0 ± 0.5 kg of BM after 8 weeks of HMB/ARG/GLN supplementation, mainly FFM (2.55 ± 0.75 kg). HMB/ARG/GLN supplementation also improved immune status, measured by increasing CD3 and CD8 cells and decreasing the HIV viral load. ... These results show that HMB/ARG/GLN can be safely used to treat AIDS- and cancer-related muscle wasting (Rathmacher et al. 2004). Berk et al. (2008) showed a strong trend towards higher FFM and BM in HMB/ARG/GLN-supplemented patients but they did not adequately test the ability of HMB/ARG/GLN to reverse or prevent cancer cachexia because most of patients did not complete the study. It was also demonstrated that both placebo and experimental amino acid mixtures significantly increased FFM, total body protein, arms and legs lean mass, and measures of physical function in rheumatoid arthritis patients but HMB/ARG/GLN supplementation was not superior to placebo in reversing rheumatoid cachexia (Marcora et al. 2005).
  5. Mochamat, Cuhls H, Marinova M, Kaasa S, Stieber C, Conrad R, Radbruch L, Mücke M (July 2016). "A systematic review on the role of vitamins, minerals, proteins, and other supplements for the treatment of cachexia in cancer: a European Palliative Care Research Centre cachexia project". Journal of Cachexia, Sarcopenia and Muscle. 8 (1): 25–39. doi:10.1002/jcsm.12127. PMC 5326814. PMID 27897391. Looking at studies with proteins and other dietary supplements the combination of HMB, arginine, and glutamine showed interesting results ... In one study, 32 patients gained an average of about 2 kg of body weight.[21] This study was one of three studies confirming the positive effects of this combination in a variety of diagnoses/conditions such as HIV/AIDS patients and healthy adults.[40] Another study, on a far larger sample base of around 470 cancer patients, found no significant difference with regard to LBM after 8 weeks however a strong trend in the direction of an increase in LBM as measured by both bio-impedance and skin-fold measurements.[22] In summary, the effect of the combination of HMB, arginine, and glutamine on weight gain should be investigated in further studies on cancer patients investigating time periods of several months.
  6. Rahman A, Wilund K, Fitschen PJ, Jeejeebhoy K, Agarwala R, Drover JW, Mourtzakis M (July 2014). "Elderly persons with ICU-acquired weakness: the potential role for β-hydroxy-β-methylbutyrate (HMB) supplementation?". Journal of Parenteral and Enteral Nutrition. 38 (5): 567–575. doi:10.1177/0148607113502545. PMID 24072740.
  7. Barth SD, Kaaks R, Johnson T, Katzke V, Gellhaus K, Schulze JJ, Olek S, Kühn T (September 2016). "The Ratio of Regulatory (FOXP3+) to Total (CD3+) T Cells Determined by Epigenetic Cell Counting and Cardiovascular Disease Risk: A Prospective Case-cohort Study in Non-diabetics". EBioMedicine. 11: 151–156. doi:10.1016/j.ebiom.2016.07.035. PMC 5049920. PMID 27499494.
  8. Berk L, James J, Schwartz A, Hug E, Mahadevan A, Samuels M, Kachnic L (October 2008). "A randomized, double-blind, placebo-controlled trial of a beta-hydroxyl beta-methyl butyrate, glutamine, and arginine mixture for the treatment of cancer cachexia (RTOG 0122)". Supportive Care in Cancer. 16 (10): 1179–1188. doi:10.1007/s00520-008-0403-7. PMID 18293016. S2CID 28498883. RESULTS: Only 37% of the patients completed protocol treatment. ... CONCLUSION: This trial was unable to adequately test the ability of beta-hydroxy beta-methylbutyrate, glutamine, and arginine to reverse or prevent lean body mass wasting among cancer patients. ... However, there was a strong trend towards an increased body mass among patients taking the Juven compound


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