Use of low-dose oral prednisone to prevent paclitaxel-induced arthralgias and myalgias.
OBJECTIVE
The aim of this study was to examine the clinical utility of low-dose oral prednisone in preventing severe paclitaxel-associated arthralgias and myalgias.


METHODS
Patients treated with paclitaxel in the gynecologic oncology program of the Cleveland Clinic Foundation who developed arthralgias/myalgias which were uncontrolled through the use of nonsteroidal anti-inflammatory medications received low-dose oral prednisone (10 mg B.I.D. starting 24 h after the completion of chemotherapy and continuing for a total of 5 days) with their next paclitaxel course.


RESULTS
Of 46 patients meeting the criteria for treatment with the oral prednisone regimen (i.e., subjective feeling of unacceptable discomfort despite the use of nonsteroidal anti-inflammatory agents), 39 (85%) experienced substantial relief of symptoms. All but one of the responding patients requested continuation of the oral prednisone regimen with subsequent paclitaxel treatment cycles. There were no significant toxicities noted in any patient receiving prednisone.


CONCLUSIONS
This low-dose oral prednisone regimen results in substantial improvement in the majority of patients experiencing significant paclitaxel-associated arthralgias/myalgias.
Markman
M
M
Department of Gynecology/Obstetrics, The Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA.
Kennedy
A
A
Webster
K
K
Kulp
B
B
Peterson
G
G
Belinson
J
J
D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D018771:Arthralgia / Q000139:chemically induced* / Q000188:drug therapy*; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006801:Humans; D009135:Muscular Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D017239:Paclitaxel / Q000009:adverse effects*; D010146:Pain / Q000139:chemically induced* / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage*
D000893:Anti-Inflammatory Agents; D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D011241:Prednisone