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Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management.

Moore, Donald C; Pellegrino, Annie E.
Ann Pharmacother; 51(9): 797-803, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28423916

OBJECTIVE:

To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). DATA SOURCES PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. STUDY SELECTION AND DATA EXTRACTION English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. DATA

SYNTHESIS:

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.

CONCLUSION:

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.