TY - JOUR
T1 - Cancer-related fatigue—pharmacological interventions
T2 - systematic review and network meta-analysis
AU - Chow, Ronald
AU - Bruera, Eduardo
AU - Sanatani, Michael
AU - Chiu, Leonard
AU - Prsic, Elizabeth
AU - Boldt, Gabriel
AU - Lock, Michael
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2023.
PY - 2023/9
Y1 - 2023/9
N2 - Introduction Cancer-related fatigue (CRF) is a very common symptom in patients with cancer, and one of the five areas of highest priority in cancer research. There is currently no consensus on pharmacologic interventions for treating CRF. The aim of this systematic review is to provide more clarity on which pharmacologic interventions may be most promising, for future clinical trials. The network meta-analysis provides the ability to compare multiple agents when no direct head-to-head trials of all agents have been performed. Methods Medline (PubMed), EMBASE and Cochrane Central Register of Controlled Trials were searched up until 5 March 2021. Studies were included if they reported on a pharmacologic intervention for CRF. Standardised mean differences and corresponding 95% CIs were computed using a random-effects maximum-likelihood model. Results This review reports on 18 studies and 2604 patients, the most comprehensive review of pharmacologic interventions for CRF at the time of this publication. Methylphenidate, modafinil and paroxetine were superior to placebo. Methylphenidate and modafinil were equivalent to one another. Paroxetine was superior to modafinil. Conclusion Paroxetine should be further studied in future trials. As well, more safety data are needed on pharmacologic interventions.
AB - Introduction Cancer-related fatigue (CRF) is a very common symptom in patients with cancer, and one of the five areas of highest priority in cancer research. There is currently no consensus on pharmacologic interventions for treating CRF. The aim of this systematic review is to provide more clarity on which pharmacologic interventions may be most promising, for future clinical trials. The network meta-analysis provides the ability to compare multiple agents when no direct head-to-head trials of all agents have been performed. Methods Medline (PubMed), EMBASE and Cochrane Central Register of Controlled Trials were searched up until 5 March 2021. Studies were included if they reported on a pharmacologic intervention for CRF. Standardised mean differences and corresponding 95% CIs were computed using a random-effects maximum-likelihood model. Results This review reports on 18 studies and 2604 patients, the most comprehensive review of pharmacologic interventions for CRF at the time of this publication. Methylphenidate, modafinil and paroxetine were superior to placebo. Methylphenidate and modafinil were equivalent to one another. Paroxetine was superior to modafinil. Conclusion Paroxetine should be further studied in future trials. As well, more safety data are needed on pharmacologic interventions.
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U2 - 10.1136/bmjspcare-2021-003244
DO - 10.1136/bmjspcare-2021-003244
M3 - Review article
C2 - 34593386
AN - SCOPUS:85168316004
SN - 2045-435X
VL - 13
SP - 274
EP - 280
JO - BMJ Supportive and Palliative Care
JF - BMJ Supportive and Palliative Care
IS - 3
ER -