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. 2018 Apr 30;25(2):e152–e167. doi: 10.3747/co.25.3883

TABLE V.

Effect of erythropoietins, stimulants, and corticosteroids on fatigue using all fatigue scales and the FACT scalea

Agent and comparators Outcome
Fatigue change score End-of-intervention fatigue score
Studies (n) Pts (n) Effect 95% CL (%) I2 p Value Studies (n) Pts (n) Effect 95% CL (%) I2 p Value
Erythropoietins
  All scales
    All interventions vs. all controls 14 3,037 −0.52 SMD −0.89, −0.14 96 0.007 2 NSP
    All interventions vs. placebo 6 1,057 −0.19 SMD −0.32, −0.07 0 0.003 1 NSP
  FACT scale
    All interventions vs. all controls 12 2,587 −2.98 WMD −4.41, −1.55 79 <0.001 0 NSP
    All interventions vs. placebo 4 683 −2.49 WMD −4.06, −0.92 0 0.002 0 NSP
Stimulants
  All scales
    All interventions vs. all controls 9 1,240 −0.16 SMD −0.34, 0.02 42 0.08 13 1,287 −0.09 SMD −0.28, 0.11 50 0.51
    All interventions vs. placebob 9 1,240 −0.16 SMD −0.34, 0.02 42 0.08 12 1,263 −0.08 SMD −0.28, 0.12 53 0.44
  Stratified by agent for all scales
    Methylphenidate vs. all controls 5 369 −0.36 SMD −0.56, −0.15 0 <0.001 6 305 −0.32 SMD −0.80, 0.17 73 0.20
    Modafinil/armodafinil vs. all controls 4 871 0.01 SMD −0.21, 0.22 36 0.94 5 905 −0.04 SMD −0.17, 0.09 0 0.51
  FACT scale
    All interventions vs. all controls 7 596 −1.35 WMD −3.47, 0.78 50 0.21 7 424 0.80 WMD −1.57, 3.18 0 0.51
    All interventions vs. placebob 7 596 −1.35 WMD −3.47, 0.78 50 0.21 7 424 0.80 WMD −1.57, 3.18 0 0.51
    Methylphenidate vs. all controls 4 346 −2.87 WMD −4.68, −1.07 0 0.002 3 150 0.71 WMD −3.18, 4.59 0 0.72
    Modafinil/armodafinil vs. all controls 3 250 1.24 WMD −2.19, 4.68 49 0.48 4 274 0.89 WMD −2.17, 3.94 3 0.57
Corticosteroids
    All interventions vs. all controls 3 165 −0.43 SMD −1.00, 0.14 67 0.14 2 NSP
    All interventions vs. placebob 3 165 −0.43 SMD −1.00, 0.14 67 0.14 2 NSP
a

Outcomes using the FACT (FACIT.org, Elmhurst, IL, U.S.A.) were rescaled (multiplied by −1) such that higher scores reflect more fatigue. One study contributed twice: results were reported separately for the lymphoma and multiple myeloma groups (Littlewood et al., 200129 and Littlewood et al., 200642).

b

All synthesized studies were placebo-controlled.

FACT = Functional Assessment of Cancer Therapy; Pts = patients; CL = confidence limits; SMD = standardized mean difference; NSP = no synthesis possible (too few studies); WMD = weighted mean difference.