前立腺癌患者の内分泌療法におけるホットフラッシュに対する塩酸ミルナシプラン(トレドミン錠)の効果の検討

Abstract

前立腺癌の内分泌療法後のホットフラッシュに対する, 塩酸ミルナシプランの効果について検討を行った。対象は9例で, 25mg/日投与群5例(A群)と50mg/日投与群4例(B群)に分けて比較した。なお, 全例の投与開始時のホットフラッシュスコアは平均23.2±9.5点, 平均発作回数は4.4±2.3回/日である。ホットフラッシュスコアおよび発作回数は, 投与6週後では2群とも改善傾向を認めた。12週後ではA群は有意な改善を認めなかったが, B群はホットフラッシュスコアは有意に改善し, 発作回数の改善を認めた。副作用は軽微で, 悪心2例便秘1例を認めたが, 投与中止後に軽快した。以上より, 塩酸ミルナシプラン50mg/日投与は前立腺癌の内分泌療法後のホットフラッシュに対して有用であることを示唆した。

We investigated the clinical efficacy of milnacipran (Serotonin-Noradrenalin Reuptake Inhibitor: SNRI) in prostate cancer patients who suffer from hot flushes. Our study included 12 patients who had taken hormone therapy for at least 3 months prior to the trial entry. All patients had severe hot flushes at least 3 times daily. Among 12 patients, 7 subjects received milnacipran 25 mg orally once a day and 5 subjects received 50mg once a day. The questionnaire was used to measure the frequency and severity of hot flushes at baseline, and at 6 and 12 weeks. At 12 weeks, 9 patients were available for the evaluation. Four patients received 50 mg per day and 5 patients received 25 mg per day. The patients with > or =50% decrease in baseline hot flash score were observed in 3 out of 4 who received 50 mg and 2 out of 5 who received 25 mg per day. The frequency of hot flushes had significantly decreased at the 12 weeks period than the baseline in the milnacipran 50 mg per day treatment group (p < 0.05, paired t-test). Adverse events were observed in 3 patients: 2 cases of nausea and 1 case of constipation. However, all of them were mild to moderate. These results indicated that milnacipran 50 mg per day therapy is effective in the treatment of hot flushes, which is the side effect of hormone therapy for prostate cancer.