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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

Journal of Clinical Oncology, In Press,July 2014 

Editors' comments: Dr. Carla Ripamonti

Corticosteroids are frequently administered to cancer patients to improve pain, fatigue, appetite. The Authors carried out a short-term randomized controlled study in patients on opioids with an average pain intensity ≥ 4 on a Numerical Rating Scale (NRS) in the previous 24 hours.  The analgesic efficacy of 32 mg/day of methylprednisolone was compared to placebo for a seven day period. The primary outcome was the pain intensity at T7; secondary outcomes were opioid consumption (oral morphine equivalents), fatigue and appetite loss (assessed by EORTC-QLQ-C30) and patients satisfaction (assessed by NRS). Fifty patients were randomized and 47 were analyzed.  No significant reduction in pain intensity and in opioid consumption were observed in the Methylprednisolone Group in respect to placebo; whereas significant improvements were observed in fatigue, appetite loss and patients satisfaction in the active drug Group.