September 2014

J Clin Oncol. 2014 Jul 7. pii: JCO.2013.54.3926. [Epub ahead of print]

Efficacy of Methylprednisolone on Pain, Fatigue, and Appetite Loss in Patients With Advanced Cancer Using Opioids: A Randomized, Placebo-Controlled, Double-Blind Trial

Paulsen O, Klepstad P, Rosland JH, Aass N , Albert E, Fayers P, Kaasa S.

In a randomized double-blind trial the analgesic efficacy methylprednisolone (16 mg twice daily) was compared with placebo for seven days in 47 patients with cancer receiving opioids. They had an average pain intensity of at least 4 out of 10. Opioid doses differed between the groups with baseline `oral morphine equivalent` being 270 mg in the methylprednisolone group and 160 mg in those assigned to placebo. After seven days there were no differences in pain intensity (the primary endpoint) or relative analgesic consumption (the secondary outcome). There were however improvements in fatigue, appetite loss, and patient satisfaction in patients taking methylprednisolone. There was no increase in adverse events from methylprednisolone over the seven day duration of this study.

Prepared by Jason Boland