Ritalin® (methylphenidate) and erythropoietins may have a modest positive effect in treating cancer-related fatigue. The details of this meta-analysis appeared in an early online publication in the Journal of the National Cancer Institute on August 11, 2008.
Fatigue is a major complaint among patients with cancer. In some instances fatigue is related to anemia (low levels of red blood cells). Anemia may often be alleviated with the use of epoetin alfa (Procrit®, Epogen®) or darbepoetin alfa (Aranesp®), two agents that stimulate the production of red blood cells.
Research has also indicated that stimulants of the central nervous system (CNS), such as Ritalin and Provigil® (modafinil), may alleviate cancer-related fatigue. Progestational steroids and paroxetine (Paxil®, an anti-depressant) have also been evaluated for possible effects on cancer-related fatigue. Each of these findings, however, needs confirmatory studies to truly understand their clinical efficacy.
Researchers from the United Kingdom recently evaluated data from literature published between 1966 and mid 2007. These researchers identified 27 clinical trials of cancer-related fatigue in almost 7,000 patients.
- Ritalin and erythropoietins were superior to placebo in alleviating cancer fatigue, although the effect was “small.”
- Four separate studies demonstrated superiority of Aranesp to placebo for treating cancer-related fatigue in anemic patients.
- No positive effects were found for progestational steroids or paroxetine.
These results indicate that cancer-related fatigue still remains a significant problem among patients with cancer, and further study is required to identify the optimal treatment.
Reference: Minton O, Richardson A, Sharpe M, et al. A systematic review and meta-analysis of pharmacological treatment of cancer-related fatigue. Journal of the National Cancer Institute [early online publication]. 2008; on August 11.
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