title: Comparative safety of filgrastim versus sargramostim in patients receiving myelosuppressive chemotherapy.
abstract: 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.
authors.affiliation: School of Pharmacy, Medical College of Virginia, Richmond, USA.
authors.forename: G
authors.initials: G
authors.lastname: Milkovich
authors.forename: R J
authors.initials: RJ
authors.lastname: Moleski
authors.forename: J F
authors.initials: JF
authors.lastname: Reitan
authors.forename: D M
authors.initials: DM
authors.lastname: Dunning
authors.forename: G A
authors.initials: GA
authors.lastname: Gibson
authors.forename: T A
authors.initials: TA
authors.lastname: Paivanas
authors.forename: S
authors.initials: S
authors.lastname: Wyant
authors.forename: R J
authors.initials: RJ
authors.lastname: Jacobs
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C081222:sargramostim; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D000069585:Filgrastim