PMID- 38348853
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 1651-226X (Electronic)
IS  - 0284-186X (Linking)
VI  - 63
DP  - 2024 Feb 13
TI  - Methylphenidate for treating fatigue in palliative cancer care - effect and side 
      effects in real-world data from a palliative care unit.
PG  - 9-16
LID - 10.2340/1651-226X.2024.24156 [doi]
AB  - BACKGROUND: Methylphenidate can be used for the treatment of cancer-related 
      fatigue (CRF), although randomized controlled trials have shown conflicting 
      results. The aim of this study was to use 'real-world' data to evaluate the 
      effect and side effects of using methylphenidate in palliative cancer care with a 
      focus on the late palliative phase and dose-response. METHOD: A retrospective 
      review of medical records from a palliative care unit in Sweden was performed to 
      evaluate the effect and adverse events (AEs) of using methylphenidate to treat 
      CRF. Univariable and multivariable regression was performed and odds ratio (OR) 
      calculated. Adjustments were made for sex, age, cancer type, dose and starting 
      treatment <4 weeks before death. RESULTS: Of the 2,419 screened patients, 112 had 
      been treated with methylphenidate for CRF. The treatment was assessed as being 
      effective in 51 patients (46%). Twenty-six patients (23%) experienced AEs that 
      were generally mild, including anxiety, palpitations, and insomnia. Patients 
      starting the treatment <4 weeks before death (n = 54) were less likely to have an 
      effect from treatment compared to those starting earlier; adjusted OR 0.24 (95% 
      CI 0.10-0.55). Doses of 20 mg and above were well-tolerated and had a higher 
      frequency of effect in the crude data but not after adjustment for confounding 
      factors. CONCLUSION: Methylphenidate is generally effective and well-tolerated 
      for the treatment of CRF in palliative care. However, patients with a short life 
      expectancy (<4 weeks) seem to benefit less from the treatment regardless of age, 
      cancer type and dose.
FAU - Almerud, Agneta
AU  - Almerud A
AD  - ASIH Stockholm Sodra, Palliative Home Care and Specialized Palliative Ward, 
      Bergtallsvagen 12, SE-125 59 Alvsjo, Sweden.
FAU - Frisk, Gabriella
AU  - Frisk G
AD  - ASIH Stockholm Sodra, Palliative Home Care and Specialized Palliative Ward, 
      Bergtallsvagen 12, SE-125 59 Alvsjo, Sweden; Department of Neurobiology, Care 
      Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska 
      Institutet, Blickagangen 16, Neo floor 7, SE-141 83, Huddinge, Sweden.
FAU - Klasson, Caritha
AU  - Klasson C
AD  - Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical 
      Geriatrics, Karolinska Institutet, Blickagangen 16, Neo floor 7, SE-141 83, 
      Huddinge, Sweden.
FAU - Bjorkhem-Bergman, Linda
AU  - Bjorkhem-Bergman L
AD  - Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical 
      Geriatrics, Karolinska Institutet, Blickagangen 16, Neo floor 7, SE-141 83, 
      Huddinge, Sweden; Stockholms Sjukhem, Palliative Medicine, Mariebergsgatan 22, 
      SE-112 19, Stockholm, Sweden. linda.bjorkhem-bergman@ki.se.
LA  - eng
PT  - Journal Article
DEP - 20240213
PL  - Sweden
TA  - Acta Oncol
JT  - Acta oncologica (Stockholm, Sweden)
JID - 8709065
RN  - 207ZZ9QZ49 (Methylphenidate)
SB  - IM
MH  - Humans
MH  - Infant, Newborn
MH  - *Methylphenidate/adverse effects
MH  - Palliative Care
MH  - Fatigue/chemically induced/drug therapy
MH  - Anxiety Disorders
MH  - *Neoplasms/complications/drug therapy
EDAT- 2024/02/13 12:46
MHDA- 2024/02/13 12:47
CRDT- 2024/02/13 08:18
PHST- 2023/10/22 00:00 [received]
PHST- 2023/12/22 00:00 [accepted]
PHST- 2024/02/13 12:47 [medline]
PHST- 2024/02/13 12:46 [pubmed]
PHST- 2024/02/13 08:18 [entrez]
AID - 10.2340/1651-226X.2024.24156 [doi]
PST - epublish
SO  - Acta Oncol. 2024 Feb 13;63:9-16. doi: 10.2340/1651-226X.2024.24156.