Cited by 68Cancer survivorship and careCancer-related cognitive impairment studiesErythropoietin and Anemia Treatment

Pharmacologic Interventions for Fatigue in Cancer and Transplantation: A Meta-Analysis

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Tomlinson, D., Robinson, P. D., Oberoi, S., Cataudella, D., Culos-Reed, N., Davis, H., Duong, N., Gibson, F. +7 more·2018·Current Oncology

Abstract

Background: Our objective was to determine whether, compared with control interventions, pharmacologic interventions reduce the severity of fatigue in patients with cancer or recipients of hematopoietic stem-cell transplantation (HSCT). Methods: For a systematic review, we searched medline, embase, the Cochrane Central Register of Controlled Trials, CINAHL, and PsychINFO for randomized trials of systemic pharmacologic interventions for the management of fatigue in patients with cancer or recipients of HSCT. Two authors independently identified studies and abstracted data. Methodologic quality was assessed using the Cochrane Risk of Bias tool. The primary outcome was fatigue severity measured using various fatigue scales. Data were synthesized using random-effects models. Results: In the 117 included trials (19,819 patients), the pharmacologic agents used were erythropoietins (n = 31), stimulants (n = 19), L-carnitine (n = 6), corticosteroids (n = 5), antidepressants (n = 5), appetite stimulants (n = 3), and other agents (n = 48). Fatigue was significantly reduced with erythropoietin [standardized mean difference (SMD): −0.52; 95% confidence interval (ci): −0.89 to −0.14] and with methylphenidate (SMD: −0.36; 95% CI: −0.56 to −0.15); modafinil (or armodafinil) and corticosteroids were not effective. Conclusions: Erythropoietin and methylphenidate significantly reduced fatigue severity in patients with cancer and in recipients of HSCT. Concerns about the safety of those agents might limit their usefulness. Future research should identify effective interventions for fatigue that have minimal adverse effects.

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  1. Zemelka T, Rolski J, Ziobro M, Michalczyk A. Opinion on influence of erythropoietin on quality of life and survival in patients with advanced non-small cell lung cancer [Polish]. Contemp Oncol (Pozn) 2007;11:37-40.
  2. Milroy R, Bajetta E, van den Berg PM, et al. Effects of epoetin alfa on anemia and patient-reported outcomes in patients with non-small cell lung cancer receiving chemotherapy: results of a European, multicenter, randomized, controlled study. Eur J Clin Med Oncol 2011;3:49-56.
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Authors
Tomlinson, D., Robinson, P. D., Oberoi, S., Cataudella, D., Culos-Reed, N., Davis, H., Duong, N., Gibson, F., Götte, M., Hinds, P., Nijhof, S. L., van der Torre, P., Cabral, S., Dupuis, L. L., & Sung, L.
Affiliations
  • Hospital for Sick Children (CA)
  • Pediatric Oncology Group (CA)
  • London Health Sciences Centre (CA)
  • University of Calgary (CA)
  • Great Ormond Street Hospital for Children NHS Foundation Trust (GB)
  • Essen University Hospital (DE)
  • Children's National (US)
  • University Medical Center Utrecht (NL)
  • University of Toronto (CA)
Corresponding author
Sung, L.
Venue
Current Oncology
Publisher
MDPI AG
Published
2018-04-01
Volume
25
Issue
2
Pages
152-167
ISSN
  • 1198-0052 (ISSN-L)
  • 1718-7729
OpenAlex
W2802547370
Cited by
68
References
154
Citations by year
2026: 3 · 2025: 4 · 2024: 9 · 2023: 6 · 2022: 9 · 2021: 17 · 2020: 8 · 2019: 10 · 2018: 2
FWCI
0.97
Type
journal article
Language
en
Open access
Locations
  • Current Oncology (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
Keywords
cancer-related fatigue, hematopoietic stem cell transplantation, pharmacological interventions, erythropoietin, methylphenidate, modafinil, armodafinil, corticosteroids, fatigue severity
MeSH terms
Central Nervous System Stimulants, Erythropoietin, Fatigue, Humans, Methylphenidate, Neoplasms, Severity of Illness Index, Hematopoietic Stem Cell Transplantation

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