There is limited evidence to support the use of methylphenidate and erythropoietin for the treatment of cancer-related fatigue in some patients, according to a systematic review of randomized controlled trials.
The review was published in the August 12 online issue of the Journal of the National Cancer Institute
Cancer-related fatigue is a common problem for patients undergoing treatment and for cancer survivors. However, the underlying causes of the problem are largely unknown, and therefore, identifying targeted therapies that mitigate the problems has been challenging.
Ollie Minton, M.D., of St. George's University of London and colleagues performed a systematic review and meta-analysis of randomized controlled trials designed to evaluate the impact of a pharmacologic agents on cancer-related fatigue. The researchers identified 27 studies in the literature, which included 6,746 patients.
The psychostimulant methylphenidate appeared to reduce cancer-related fatigue by about 30 percent relative to placebo. Erythropoietin also appeared to reduce cancer-related fatigue by about 30 percent, compared with placebo, in anemic cancer patients who were undergoing chemotherapy. Darbopoetin appeared to reduce cancer-related fatigue only 13 percent in anemic patients relative to placebo. Other agents studied, including the antidepressant paroxetine, were no better than placebo.
"The overall effect sizes that we are reporting for all classes of drugs are small," the authors write. "The potential implications for current practice and future research should be tempered as a result of this finding."
- Minton et al. A Systematic Review and Meta-Analysis of the Pharmacological Treatment of Cancer-Related Fatigue. JNCI Journal of the National Cancer Institute, 2008; DOI: 10.1093/jnci/djn250
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