Moore Donald C, Pellegrino Annie E
1 Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA.
Ann Pharmacother. 2017 Sep;51(9):797-803. doi: 10.1177/1060028017706373. Epub 2017 Apr 19.
To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP).
PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain.
English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated.
A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim.
Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.
回顾聚乙二醇化重组人粒细胞刺激因子诱导的骨痛（PIBP）的发生率、危险因素及处理方法。
使用“聚乙二醇化重组人粒细胞刺激因子”和“骨痛”等检索词，于1980年至2017年3月31日在PubMed数据库进行检索。
纳入评估PIBP发生率、危险因素及处理方法的英文人体研究和综述。
共有3项随机前瞻性研究和2项回顾性研究评估了PIBP的药物治疗。萘普生与安慰剂相比，可减轻聚乙二醇化重组人粒细胞刺激因子所致骨痛的程度、发生率及持续时间。氯雷他定预防性减轻骨痛发生率无效，但一项评估氯雷他定与法莫替丁联合抗组胺阻滞的回顾性研究表明，在聚乙二醇化重组人粒细胞刺激因子给药前使用可降低骨痛发生率。
萘普生对PIBP有效。抗组胺药虽常用，但支持其使用的数据较少。聚乙二醇化重组人粒细胞刺激因子和阿片类药物减量也可能是潜在的处理方法；然而，支持这些治疗方式的数据很少。
