Oral loratadine in the management of G-CSF-induced bone pain: a pilot study

Duggan, Caitriona; Murphy, Louise; Costello, Vicky; Leary, Eilis O; Yousif, Ala; Blazkova, Silvie; Dowling, Maura

doi:10.12968/bjon.2019.28.4.s4

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…Although many of G-CSF drugs were shown to be relatively safe, the major adverse effect of prophylactic use of these G-CSF-related drugs were bone pain ( 26 , 27 ), bleomycin-induced pulmonary toxicities ( 28 ), and other toxicities ( 29 ), which could dramatically prolong/delay cancer chemotherapy, increase the treatment cost, and even jeopardize clinical outcome. In our study, only 10 (6.6%) patients experienced PEG-rhG-CSF-associated adverse effect, indicating a well-tolerated effect of the half dose of PEG-rhG-CSF.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety for the Use of Half-Dosed Pegylated Granulocyte Colony-Stimulating Factors in Preventing Febrile Neutropenia During Chemotherapy in Patients With Malignant Tumors: A Multicenter, Open-Labeled, Single-Arm Phase 2 Trial

Mei

Wang

et al. 2022

Front. Oncol.

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BackgroundProphylactic granulocyte-colony stimulating factor (G-CSF) has been shown to effectively prevent febrile neutropenia (FN) and grade 3/4 neutropenia during myelosuppressive treatment. The present study reports the clinical efficacy and safety of the prophylactic use of G-CSF with a half dose for cancer patients with an intermediate risk of FN combined with ≥1 patient-specific risk during multiple chemotherapy.MethodsThis multicenter, one-arm, and open-label clinical study involved 151 patients [median age, 54 years old (range, 46.0–62.5); 38.4% female] with malignant tumors, including >20 different cancers. These patients underwent a total of 604 cycles of chemotherapy and received a half dose of PEG-rhG-CSF administration prior to each cycle.ResultsThe incidence rate of FN was 3.3% for this cohort during chemotherapy. Chemotherapy delay occurred in 6 (4.0%) patients for 12 (2.0%) cycles. Early termination of cancer treatment occurred in 14 (9.3%) patients. In this cohort, 23 (15.2%) patients required antibiotic use during courses of chemotherapy. A total of 28 (18.5%) patients experienced clear adverse effects during cancer treatment.ConclusionThe prophylactic PEG-rhG-CSF with a half dose can both efficaciously and safely prevent neutropenia for patients of diverse cancers with an intermediate risk of FN combined with ≥1 patient-specific risk during chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety for the Use of Half-Dosed Pegylated Granulocyte Colony-Stimulating Factors in Preventing Febrile Neutropenia During Chemotherapy in Patients With Malignant Tumors: A Multicenter, Open-Labeled, Single-Arm Phase 2 Trial

Mei

Wang

et al. 2022

Front. Oncol.

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“…Patients with bone pain of all grades in cycle 1 had 42.5% under treatment with loratadine. Additionally, in a pilot study of 12 patients with various types of cancer (breast, genitourinary and colorectal) receiving chemotherapy and pegfilgrastim, they were treated with loratadine for 5 cycles of chemotherapy [ 74 ]. This treatment produced effective pain management in patients who developed pain from the first dose of pegfilgrastim.…”

Section: Novel Strategies For Neuropharma- Cological Management Of Bone Tumor Painmentioning

confidence: 99%

Neurophysiological Mechanisms Related to Pain Management in Bone Tumors

Romero-Morelos

Ruvalcaba-Paredes

Garciadiego-Cázares

et al. 2021

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Background: Primary and metastatic bone tumor incidence has increased in the last years. Pain is a common symptom and is one of the most important related factor to the decrease of quality of life in these patients. Different pain management strategies are not completely effective and many patients afflicted by cancer pain cannot be controlled properly. In this sense we need to elucidate the neurophysiology of cancer-induced pain contemplating other quality of life components such as inflammation, neuropathies and cognitive components regarding bone tumors, and thus pave the way for novel therapeutic approaches in this field. Aim: Identify the neurophysiology of the mechanisms related to pain management in bone tumors. Method: Advanced searches were performed in scientific databases: PubMed, ProQuest, EBSCO, and the Science Citation index to get information about the neurophysiology mechanisms related to pain management in bone tumors. Results: The central and peripheral mechanisms that promote bone cancer pain are poorly understood. Studies have shown that bone cancer could be related to neurochemicals produced by tumor and inflammatory cells, coupled with peripheral sensitization due to nerve compression and injury caused by tumor growth. Activity of mesolimbic dopaminergic neurons, substance P, cysteine/glutamate antiporter, and other neurochemical dynamic’s brings us putative strategies to suggest better and efficient treatments against pain in cancer patients. Conclusion: Cancer-induced bone pain could include neuropathic and inflammatory pain, but with different modifications to the periphery tissue, nerves and neurochemical changes in different neurological levels. In this sense, here we explore opportunity areas in pharmacological and non-pharmacological pain management, according to pain-involved mechanisms.

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