Drug not linked to reduced fatigue; may be more helpful in advanced cancer or worse fatigue

-- Eric Metcalf

Friday, July 16, 2010 (Last Updated: 07/19/2010)

FRIDAY, July 16 (HealthDay News) -- Long-acting methylphenidate does not appear to reduce cancer-related fatigue in general, though it may be helpful in patients with more advanced disease or more severe fatigue, according to research published online July 12 in the Journal of Clinical Oncology.

Amanda R. Moraska, of the Mayo Clinic in Rochester, Minn., and colleagues analyzed data from 148 adults with cancer and a history of cancer-related fatigue. Patients were randomly assigned to methylphenidate with a target dose of 54 mg daily or placebo for four weeks. The primary outcome measure was the Brief Fatigue Inventory.

The researchers found no evidence that methylphenidate improved cancer-related fatigue compared to placebo in this population. The drug also didn't show significant benefit for secondary end points, including quality-of-life variables and cancer-related fatigue change from baseline. However, patients with more severe fatigue or with more advanced disease appeared to have some improvement in fatigue with the drug. There were also increased nervousness levels and appetite loss in patients taking methylphenidate.

"Where do we go from here? Fatigue is a complex multidimensional symptom, and it is therefore unlikely to be successfully managed with single pharmacologic or non-pharmacologic interventions. Patients are likely to require a combination of counseling, increased physical activity, correction of hormonal and metabolic abnormalities, and pharmacologic interventions aimed at body composition, inflammation, and brain function," write the authors of an accompanying editorial.

Ortho-McNeil-Janssen Scientific Affairs provided the study drug and matching placebo.

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Specialties Hematology & Oncology

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