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Methylphenidate for treating fatigue in palliative cancer care - effect and side effects in real-world data from a palliative care unit.
Almerud, Agneta; Frisk, Gabriella; Klasson, Caritha; Björkhem-Bergman, Linda.
Afiliación
  • Almerud A; ASIH Stockholm Södra, Palliative Home Care and Specialized Palliative Ward, Bergtallsvägen 12, SE-125 59 Älvsjö, Sweden.
  • Frisk G; ASIH Stockholm Södra, Palliative Home Care and Specialized Palliative Ward, Bergtallsvägen 12, SE-125 59 Älvsjö, Sweden; Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickagången 16, Neo floor 7, SE-141 83, Huddinge, Sweden.
  • Klasson C; Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickagången 16, Neo floor 7, SE-141 83, Huddinge, Sweden.
  • Björkhem-Bergman L; Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Blickagången 16, Neo floor 7, SE-141 83, Huddinge, Sweden; Stockholms Sjukhem, Palliative Medicine, Mariebergsgatan 22, SE-112 19, Stockholm, Sweden. linda.bjorkhem-bergman@ki.se.
Acta Oncol ; 63: 9-16, 2024 Feb 13.
Article en En | MEDLINE | ID: mdl-38348853
ABSTRACT

BACKGROUND:

Methylphenidate can be used for the treatment of cancer-related fatigue (CRF), although randomized controlled trials have shown conflicting results. The aim of this study was to use 'real-world' data to evaluate the effect and side effects of using methylphenidate in palliative cancer care with a focus on the late palliative phase and dose-response.

METHOD:

A retrospective review of medical records from a palliative care unit in Sweden was performed to evaluate the effect and adverse events (AEs) of using methylphenidate to treat CRF. Univariable and multivariable regression was performed and odds ratio (OR) calculated. Adjustments were made for sex, age, cancer type, dose and starting treatment <4 weeks before death.

RESULTS:

Of the 2,419 screened patients, 112 had been treated with methylphenidate for CRF. The treatment was assessed as being effective in 51 patients (46%). Twenty-six patients (23%) experienced AEs that were generally mild, including anxiety, palpitations, and insomnia. Patients starting the treatment <4 weeks before death (n = 54) were less likely to have an effect from treatment compared to those starting earlier; adjusted OR 0.24 (95% CI 0.10-0.55). Doses of 20 mg and above were well-tolerated and had a higher frequency of effect in the crude data but not after adjustment for confounding factors.

CONCLUSION:

Methylphenidate is generally effective and well-tolerated for the treatment of CRF in palliative care. However, patients with a short life expectancy (<4 weeks) seem to benefit less from the treatment regardless of age, cancer type and dose.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Metilfenidato / Neoplasias Tipo de estudio: Clinical_trials Límite: Humans / Newborn Idioma: En Revista: Acta Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suecia
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Metilfenidato / Neoplasias Tipo de estudio: Clinical_trials Límite: Humans / Newborn Idioma: En Revista: Acta Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suecia