Comparative Safety of Filgrastim versus Sargramostim in Patients Receiving Myelosuppressive Chemotherapy
作者:Gary Milkovich、Ronald J. Moleski、John F. Reitan、David M. Dunning、Gene A. Gibson、Thomas A. Paivanas、Susan Wyant、R. Jake Jacobs
DOI:10.1592/phco.20.19.1432.34861
日期:2000.12
Study Objective. To compare rates of adverse events with filgrastim versus sargramostim when given prophylactically to patients receiving myelosuppressive chemotherapy. Design. Retrospective review with center crossover. Setting. Ten United States outpatient chemotherapy centers. Patients. Four hundred ninety patients treated for lung, breast, lymphatic system, or ovarian tumors. Intervention. Prophylactic use of filgrastim or sargramostim, with dosages at investigator discretion. Measurements and Main Results. The frequency and severity of adverse events and the frequency of switching to the alternative CSF were assessed. There was no difference in infectious fever. Fever unexplained by infection was more common with sargramostim (7% vs 1%, p<0.001), as were fatigue, diarrhea, injection site reactions, other dermatologic disorders, and edema (all p<0.05). Skeletal pain was more frequent with filgrastim (p=0.06). Patients treated with sargramostim switched to the alternative agent more often (p<0.001). Conclusion. Adverse events were less frequent with filgrastim than with sargramostim, suggesting that quality of life and treatment costs also may differ.
研究目的:比较在接受骨髓抑制化疗的患者中,预防性使用菲尔格司亭与沙格莫司亭的副作用发生率。
设计:回顾性研究,具有中心交叉设计。
设置:美国十个门诊化疗中心。
患者:490名接受肺癌、乳腺癌、淋巴系统或卵巢肿瘤治疗的患者。
干预:在研究者的判断下,预防性使用菲尔格司亭或沙格莫司亭,剂量由研究者自行决定。
测量与主要结果:评估了副作用的发生频率和严重程度,以及转用替代性粒细胞生长因子的频率。感染引起的发热没有差异。与沙格莫司亭相比,不明原因的发热更为常见(7%对1%,p<0.001),疲劳、腹泻、注射部位反应、其他皮肤病和水肿也更常见(均p<0.05)。骨骼疼痛在使用菲尔格司亭的患者中更为频繁(p=0.06)。接受沙格莫司亭治疗的患者更常转用替代药物(p<0.001)。
结论:与沙格莫司亭相比,使用菲尔格司亭的副作用发生率更低,这表明生活质量和治疗费用也可能存在差异。