Comparative safety of filgrastim versus sargramostim in patients receiving myelosuppressive chemotherapy.
OBJECTIVE
To compare rates of adverse events with filgrastim versus sargramostim when given prophylactically to patients receiving myelosuppressive chemotherapy.


METHODS
Retrospective review with center crossover.


METHODS
Ten United States outpatient chemotherapy centers.


METHODS
Four hundred ninety patients treated for lung, breast, lymphatic system, or ovarian tumors.


METHODS
Prophylactic use of filgrastim or sargramostim, with dosages at investigator discretion.


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).


CONCLUSIONS
Adverse events were less frequent with filgrastim than with sargramostim, suggesting that quality of life and treatment costs also may differ.
Milkovich
G
G
School of Pharmacy, Medical College of Virginia, Richmond, USA.
Moleski
R J
RJ
Reitan
J F
JF
Dunning
D M
DM
Gibson
G A
GA
Paivanas
T A
TA
Wyant
S
S
Jacobs
R J
RJ
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018592:Cross-Over Studies; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control; D011994:Recombinant Proteins; D012189:Retrospective Studies
D000970:Antineoplastic Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C081222:sargramostim; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D000069585:Filgrastim