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  1. Jason W Boland
  1. Senior Clinical Lecturer and Honorary Consultant in Palliative Medicine, Hull York Medical School, Hull, UK

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Efficacy of methylprednisolone on pain, fatigue and appetite loss in patients with advanced cancer using opioids: a randomized, placebo-controlled, double-blind trial

▸Paulsen O, Klepstad P, Rosland JH, et al. J Clin Oncol 2014:pii: JCO.2013.54.3926. Published Online First. J Clin Oncol 2014 Oct 10;32(29):3221–8.

In a randomised double-blind trial the analgesic efficacy of methylprednisolone (16 mg twice daily) was compared with placebo for 7 days in 47 patients with cancer receiving opioids. They had an average pain intensity of at least 4 of 10. Opioid doses differed between the groups with baseline ‘oral morphine equivalent’ being 270 mg in the methylprednisolone group and 160 mg in those assigned to placebo. After 7 days there were no differences in pain intensity (the primary end point) or in relative analgesic consumption (the secondary outcome). There were however improvements in fatigue, appetite loss and patient satisfaction in patients taking methylprednisolone. There was no increase in adverse events from methylprednisolone over the 7-day duration of this study.

Thoughts of self-harm and depression as prognostic factors in palliative care patients

▸Lloyd-Williams M, Payne S, Reeve J, et al. J Affect Disord 2014;166:324–9.

This longitudinal study based in 20 palliative care day units in England, explored whether depression and patient reports of thoughts of self-harm were prognostic factors for survival in 629 patients with advanced cancer. Baseline measures were completed on all these patients, with 494 patients (79%), 405 (64%) and 349 (55%) completing follow-up at 8, 16 and 24 weeks, respectively. Higher …

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