Antiemetic Corticosteroid Rotation from Dexamethasone to Methylprednisolone to Prevent Dexamethasone‐Induced Hiccup in Cancer Patients Treated with Chemotherapy: A Randomized, Single‐Blind, Crossover Phase III Trial

• Published in: The oncologist (Dayton, Ohio) Ohio), 2017-11, Vol.22 (11), p.1354-1361
• Main Authors: Go, Se‐Il, Koo, Dong‐Hoe, Kim, Seung Tae, Song, Haa‐Na, Kim, Rock Bum, Jang, Joung‐Soon, Oh, Sung Yong, Lee, Kyung Hee, Lee, Soon Il, Kim, Seong‐Geun, Park, Lee Chun, Lee, Sang‐Cheol, Park, Byeong‐Bae, Ji, Jun Ho, Yi, Seong Yoon, Lee, Yun‐Gyoo, Yun, Jina, Bruera, Eduardo, Hwang, In Gyu, Kang, Jung Hun
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - adverse effects; Adult; Aged; Aged, 80 and over; Antiemetics - administration & dosage; Antiemetics - adverse effects; Cancer chemotherapy; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Drug-Related Side Effects and Adverse Reactions - classification; Drug-Related Side Effects and Adverse Reactions - drug therapy; Drug-Related Side Effects and Adverse Reactions - pathology; Emesis; Hiccup; Hiccup - chemically induced; Hiccup - prevention & control; Humans; Male; Methylprednisolone; Methylprednisolone - administration & dosage; Methylprednisolone - adverse effects; Middle Aged; Neoplasms - complications; Neoplasms - drug therapy; Symptom Management and Supportive Care; Vomiting - drug therapy; Vomiting - pathology
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1634/theoncologist.2017-0129

Background To assess whether the rotation of dexamethasone to methylprednisolone decreases the intensity of dexamethasone‐induced hiccup (DIH) in cancer patients treated with chemotherapy. Materials and Methods Adult patients who experienced DIH within 3 days after the administration of dexamethasone as an antiemetic were screened. Eligible patients were randomly assigned to receive dexamethasone (n = 33) or methylprednisolone (n = 32) as an antiemetic (randomization phase). In the next cycle of chemotherapy, the dexamethasone group received methylprednisolone and vice versa in the methylprednisolone group (crossover phase). The primary endpoint was the difference in hiccup intensity as measured using the numeric rating scale (NRS) between two groups. Results No female patients were enrolled, although the study did not exclude them. At the randomization phase, hiccup frequency was 28/33 (84.8%) in the dexamethasone group versus 20/32 (62.5%) in the methylprednisolone group (p = .04). Intensity of hiccup was significantly higher in the dexamethasone group than that in the methylprednisolone group (mean NRS, 3.5 vs. 1.4, p