Rojí Rocío, Centeno Carlos
Departamento de Medicina Paliativa, Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Navarra, Spain.
Curr Opin Support Palliat Care. 2017 Dec;11(4):299-305. doi: 10.1097/SPC.0000000000000296.
To review recent evidence on the efficacy and safety of methylphenidate as a symptomatic treatment of patients with cancer-related fatigue (CRF).
Five clinical trials published since 2011 were identified. Two of these concluded that methylphenidate is more efficacious than placebo in providing relief from CRF, but the remaining three showed no difference in favour of methylphenidate. The studies were heterogeneous as per the dosage, scales used for evaluating fatigue and the target group studied. None of the studies detected serious reactions, and only mild and infrequent side-effects of methylphenidate were reported. Three new metanalyses show the slightly superior effect of methylphenidate compared to placebo in CRF.
Overall, literature supports the existence of moderate benefit of methylphenidate in CRF, backed up by weak evidence. Future studies should aim at better identifying the profile of patients who would benefit most from this pharmacological intervention.
回顾近期有关哌甲酯作为癌症相关疲劳（CRF）患者对症治疗的疗效和安全性的证据。
确定了自2011年以来发表的五项临床试验。其中两项得出结论，哌甲酯在缓解CRF方面比安慰剂更有效，但其余三项未显示哌甲酯有优势。这些研究在剂量、评估疲劳的量表以及所研究的目标群体方面存在异质性。没有研究检测到严重反应，仅报告了哌甲酯轻微且不常见的副作用。三项新的荟萃分析表明，在CRF中哌甲酯比安慰剂的效果略优。
总体而言，文献支持哌甲酯在CRF中有适度益处，证据薄弱。未来的研究应旨在更好地确定最能从这种药物干预中获益的患者特征。
