Dexamethasone in addition to metoclopramide for chronic nausea in patients with advanced cancer: a randomized controlled trial.
Chronic nausea occurs in most patients with advanced cancer. This study was done to assess the antiemetic effects of dexamethasone in patients with chronic nausea refractory to metoclopramide. Secondary outcomes included appetite, fatigue, and pain. Fifty-one patients who had nausea (> or = 3/10 on a 0-10 scale) for > or = 2 weeks despite 48 hours of oral metoclopramide therapy (40-60 mg/day) were enrolled. Patients received 20 mg/day dexamethasone (DM) orally (n = 25) or placebo (n = 26) for severe nausea in addition to metoclopramide (60 mg/day orally). At baseline the mean nausea intensity ratings in the DM and placebo groups were 8.0 and 7.4. At Day 8 they were 2.1 and 2.0, respectively. At Day 3 and Day 8, the mean difference in nausea intensity for the DM and placebo groups was 4.5 and 2.9 (P = 0.16) and 5.9 and 5.7 (P = 0.85), respectively. Improvement in appetite and fatigue were observed on Day 3 and Day 8 in both groups as compared with the baseline. Pain, vomiting, well-being, and quality of life remained unchanged in both groups at both times. We conclude that DM was not superior to placebo in the management of chronic nausea in our patients with advanced cancer.
Department of Palliative Care & Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston 77030, USA.
Eduardo
E
Bruera
Jario Ricardo
JR
Moyano
Raul
R
Sala
Maria Antonieta
MA
Rico
Snezanna
S
Bosnjak
Mariela
M
Bertolino
Jie
J
Willey
Florian
F
Strasser
J Lynn
JL
Palmer
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage; D002908:Chronic Disease; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D004338:Drug Combinations; D004351:Drug Resistance; D015673:Fatigue Syndrome, Chronic / Q000188:drug therapy / Q000209:etiology; D001068:Feeding and Eating Disorders / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy* / Q000209:etiology; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods*; D013727:Terminal Care / Q000379:methods*; D016896:Treatment Outcome
D000932:Antiemetics; D004338:Drug Combinations; D003907:Dexamethasone; D008787:Metoclopramide