PURPOSE: A randomized clinical trial from Great Britain suggested a possible beneficial effect of acetylsalicylate in the prevention of radiation-induced bowel toxicity. Olsalazine is an orally administered drug designed to deliver 5-aminosalicylate to the large bowel with minimal systemic absorption. A randomized clinical trial was undertaken to assess the effectiveness of olsalazine in preventing acute diarrhea in patients receiving pelvic radiation therapy. METHODS AND MATERIALS: Patients receiving pelvic radiation therapy were randomized, in double-blind fashion, to olsalazine 250 mg, two capsules twice daily, or an identical appearing placebo, two capsules twice daily. Patients were then evaluated weekly during radiation therapy for the primary study endpoint, diarrhea, as well as rectal bleeding, abdominal cramping, and tenesmus. RESULTS: The study was closed early, after entry of 58 evaluable patients, when a preliminary analysis showed excessive diarrhea in patients randomized to olsalazine. The incidence and severity of diarrhea were worse in patients randomized to olsalazine (p = 0.0036). Sixty percent of the patients randomized to olsalazine experienced Grade 3 or 4 diarrhea compared to only 14% randomized to placebo. There was also a trend toward higher incidence and greater severity of abdominal cramping in patients who were randomized to olsalazine (p = 0.084). CONCLUSION: Administration of olsalazine during pelvic radiation therapy resulted in an increased incidence and severity of diarrhea. Olsalazine is contraindicated in patients receiving pelvic radiation therapy.
RCT Entities:
PURPOSE: A randomized clinical trial from Great Britain suggested a possible beneficial effect of acetylsalicylate in the prevention of radiation-induced bowel toxicity. Olsalazine is an orally administered drug designed to deliver 5-aminosalicylate to the large bowel with minimal systemic absorption. A randomized clinical trial was undertaken to assess the effectiveness of olsalazine in preventing acute diarrhea in patients receiving pelvic radiation therapy. METHODS AND MATERIALS: Patients receiving pelvic radiation therapy were randomized, in double-blind fashion, to olsalazine 250 mg, two capsules twice daily, or an identical appearing placebo, two capsules twice daily. Patients were then evaluated weekly during radiation therapy for the primary study endpoint, diarrhea, as well as rectal bleeding, abdominal cramping, and tenesmus. RESULTS: The study was closed early, after entry of 58 evaluable patients, when a preliminary analysis showed excessive diarrhea in patients randomized to olsalazine. The incidence and severity of diarrhea were worse in patients randomized to olsalazine (p = 0.0036). Sixty percent of the patients randomized to olsalazine experienced Grade 3 or 4 diarrhea compared to only 14% randomized to placebo. There was also a trend toward higher incidence and greater severity of abdominal cramping in patients who were randomized to olsalazine (p = 0.084). CONCLUSION: Administration of olsalazine during pelvic radiation therapy resulted in an increased incidence and severity of diarrhea. Olsalazine is contraindicated in patients receiving pelvic radiation therapy.
Authors: Robert C Miller; Daniel G Petereit; Jeff A Sloan; Heshan Liu; James A Martenson; James D Bearden; Ronald Sapiente; Grant R Seeger; Rex B Mowat; Ben Liem; Matthew J Iott; Charles L Loprinzi Journal: Int J Radiat Oncol Biol Phys Date: 2016-04-23 Impact factor: 7.038
Authors: Rachel J Gibson; Dorothy M K Keefe; Rajesh V Lalla; Emma Bateman; Nicole Blijlevens; Margot Fijlstra; Emily E King; Andrea M Stringer; Walter J F M van der Velden; Roger Yazbeck; Sharon Elad; Joanne M Bowen Journal: Support Care Cancer Date: 2012-11-10 Impact factor: 3.603
Authors: Pamela J Atherton; Michele Y Halyard; Jeff A Sloan; Robert C Miller; Richard L Deming; T H Patricia Tai; Kathy J Stien; James A Martenson Journal: Support Care Cancer Date: 2012-11-15 Impact factor: 3.603
Authors: James A Martenson; Michele Y Halyard; Jeff A Sloan; Gary M Proulx; Robert C Miller; Richard L Deming; Stephen J Dick; Harold A Johnson; T H Patricia Tai; Angela W Zhu; Joan Keit; Kathy J Stien; Pamela J Atherton Journal: J Clin Oncol Date: 2008-09-02 Impact factor: 44.544