Comparative Safety of Filgrastim versus Sargramostim in Patients Receiving Myelosuppressive Chemotherapy

• Published in: Pharmacotherapy Vol. 20; no. 12; pp. 1432 - 1440
• Main Authors: Milkovich, Gary, Moleski, Ronald J., Reitan, John F., Dunning, David M., Gibson, Gene A., Paivanas, Thomas A., Wyant, Susan, Jacobs, R. Jake
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-12-2000; Pharmacotherapy
• Subjects: Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Cross-Over Studies; Drug toxicity and drugs side effects treatment; Female; Filgrastim; Granulocyte Colony-Stimulating Factor - adverse effects; Granulocyte Colony-Stimulating Factor - therapeutic use; Granulocyte-Macrophage Colony-Stimulating Factor - adverse effects; Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use; Humans; Male; Medical sciences; Middle Aged; Miscellaneous (drug allergy, mutagens, teratogens...); Neoplasms - drug therapy; Neutropenia - chemically induced; Neutropenia - prevention & control; Pharmacology. Drug treatments; Recombinant Proteins; Retrospective Studies; Antineoplastic agent; Human; Prevention; Chemotherapy; Granulocyte colony stimulating factor; Toxicity; Sargramostim; Malignant tumor; Comparative study; Granulocyte macrophage colony stimulating factor; Filgrastim
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1592/phco.20.19.1432.34861

Study Objective. To compare rates of adverse events with filgrastim versus sargramostim when given prophylactically to patients receiving myelosuppressive chemotherapy.
Design. Retrospective review with center crossover.
Setting. Ten United States outpatient chemotherapy centers.
Patients. Four hundred ninety patients treated for lung, breast, lymphatic system, or ovarian tumors.
Intervention. Prophylactic use of filgrastim or sargramostim, with dosages at investigator discretion.
Measurements and Main 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).
Conclusion. Adverse events were less frequent with filgrastim than with sargramostim, suggesting that quality of life and treatment costs also may differ.