My husband recently went though an autologous stem cell transplant. He found that taking loratadine [Claritin] with Neupogen shots really cut down on the bone pain a lot. He is also finding that if he stops the loratadine the bone pain comes back. He's a month post transplant so I don't think the Neupogen is still effecting his bones.
In trying to research how this might work, I found an article from 2008 on Periactin [cyproheptadine], which is also an antihistamine (H2 blocker), which they thought had some anti-myeloma activity but no follow up.
Has anyone had any experience with this?
Thanks for your help.
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Re: Claritin (loratadine), Neupogen & Periactin
Almost certainly your husband does NOT have residual bone pain related to the Neupogen a month later. If he has persistent bone pain, it is from another source.
I am unaware of any studies showing antihistamines having anti-myeloma effects. I completed a search of clinicaltrials.gov for "anti-histamines AND myeloma" and there were no registered clinical trials.
I am unaware of any studies showing antihistamines having anti-myeloma effects. I completed a search of clinicaltrials.gov for "anti-histamines AND myeloma" and there were no registered clinical trials.
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Dr. David Vesole - Name: David H. Vesole, M.D., Ph.D., F.A.C.P.
Re: Claritin (loratadine), Neupogen & Periactin
Hi Jode,
At Dr. Vesole's prompting, we looked a bit further into your question, and found that there has indeed been one pre-clinical study that has found that Periactin (cyproheptadine) appears to have anti-myeloma activity.
We are including below the abstract for the study as well as a link to the full article, which is available online free of charge and without any registration requirement.
Also included below is the abstract of another pre-clinical study related to Periactin. It looks at combining Periactin with Velcade, but the target disease is mantle cell lymphoma, not myeloma. Still, it's worth knowing about.
These studies suggest that Periactin has potential as an anti-myeloma drug. However, as Dr. Vesole said, there are not currently any clinical trials looking at Periactin or any other antihistamine as an anti-myeloma drug.
Hope this helps!
- The Beacon Staff
ABSTRACTS AND LINKS:
Cyproheptadine displays preclinical activity in myeloma and leukemia.
Mao X, Liang SB, Hurren R, and others
Blood. 2008 Aug 1;112(3):760-9.
Abstract
D-cyclins are regulators of cell division that act in a complex with cyclin-dependent kinases to commit cells to a program of DNA replication. D-cyclins are overexpressed in many tumors, including multiple myeloma and leukemia, and contribute to disease progression and chemoresistance. To better understand the role and impact of D-cyclins in hematologic malignancies, we conducted a high throughput screen for inhibitors of the cyclin D2 promoter and identified the drug cyproheptadine. In myeloma and leukemia cells, cyproheptadine decreased expression of cyclins D1, D2, and D3 and arrested these cells in the G(0)/G(1) phase. After D-cyclin suppression, cyproheptadine induced apoptosis in myeloma and leukemia cell lines and primary patient samples preferentially over normal hematopoietic cells. In mouse models of myeloma and leukemia, cyproheptadine inhibited tumor growth without significant toxicity. Cyproheptadine-induced apoptosis was preceded by activation of the mitochondrial pathway of caspase activation and was independent of the drug's known activity as an H1 histamine and serotonin receptor antagonist. Thus, cyproheptadine represents a lead for a novel therapeutic agent for the treatment of malignancy. Because the drug is well tolerated and already approved in multiple countries for clinical use as an antihistamine and appetite stimulant, it could be moved directly into clinical trials for cancer.
Full text: http://bloodjournal.hematologylibrary.org/content/112/3/760.long
The anti-histaminic cyproheptadine synergizes the antineoplastic activity of bortezomib in mantle cell lymphoma through its effects as a histone deacetylase inhibitor.
Paoluzzi L, Scotto L, Marchi E, Seshan VE, O'Connor OA.
British Journal of Haematology. 2009 Sep;146(6):656-9
Abstract
Cyproheptadine, an inhibitor of the H1 histamine receptors, has recently shown activity in models of leukaemia and myeloma, presumably through inhibition of cyclin-D expression. Mantle cell lymphoma (MCL) is an aggressive subtype of non-Hodgkin lymphoma characterized by overexpression of cyclin-D1. We investigated the effect of cyproheptadine alone and in combination with the proteasome inhibitor bortezomib in models of MCL. The combination of these drugs was mathematically synergistic, producing significant reductions in the mitochondrial membrane potential leading to apoptosis. In a severe combined immunodeficient beige mouse model, cyproheptadine plus bortezomib demonstrated a statistically significant advantage compared to either agent alone.
At Dr. Vesole's prompting, we looked a bit further into your question, and found that there has indeed been one pre-clinical study that has found that Periactin (cyproheptadine) appears to have anti-myeloma activity.
We are including below the abstract for the study as well as a link to the full article, which is available online free of charge and without any registration requirement.
Also included below is the abstract of another pre-clinical study related to Periactin. It looks at combining Periactin with Velcade, but the target disease is mantle cell lymphoma, not myeloma. Still, it's worth knowing about.
These studies suggest that Periactin has potential as an anti-myeloma drug. However, as Dr. Vesole said, there are not currently any clinical trials looking at Periactin or any other antihistamine as an anti-myeloma drug.
Hope this helps!
- The Beacon Staff
ABSTRACTS AND LINKS:
Cyproheptadine displays preclinical activity in myeloma and leukemia.
Mao X, Liang SB, Hurren R, and others
Blood. 2008 Aug 1;112(3):760-9.
Abstract
D-cyclins are regulators of cell division that act in a complex with cyclin-dependent kinases to commit cells to a program of DNA replication. D-cyclins are overexpressed in many tumors, including multiple myeloma and leukemia, and contribute to disease progression and chemoresistance. To better understand the role and impact of D-cyclins in hematologic malignancies, we conducted a high throughput screen for inhibitors of the cyclin D2 promoter and identified the drug cyproheptadine. In myeloma and leukemia cells, cyproheptadine decreased expression of cyclins D1, D2, and D3 and arrested these cells in the G(0)/G(1) phase. After D-cyclin suppression, cyproheptadine induced apoptosis in myeloma and leukemia cell lines and primary patient samples preferentially over normal hematopoietic cells. In mouse models of myeloma and leukemia, cyproheptadine inhibited tumor growth without significant toxicity. Cyproheptadine-induced apoptosis was preceded by activation of the mitochondrial pathway of caspase activation and was independent of the drug's known activity as an H1 histamine and serotonin receptor antagonist. Thus, cyproheptadine represents a lead for a novel therapeutic agent for the treatment of malignancy. Because the drug is well tolerated and already approved in multiple countries for clinical use as an antihistamine and appetite stimulant, it could be moved directly into clinical trials for cancer.
Full text: http://bloodjournal.hematologylibrary.org/content/112/3/760.long
The anti-histaminic cyproheptadine synergizes the antineoplastic activity of bortezomib in mantle cell lymphoma through its effects as a histone deacetylase inhibitor.
Paoluzzi L, Scotto L, Marchi E, Seshan VE, O'Connor OA.
British Journal of Haematology. 2009 Sep;146(6):656-9
Abstract
Cyproheptadine, an inhibitor of the H1 histamine receptors, has recently shown activity in models of leukaemia and myeloma, presumably through inhibition of cyclin-D expression. Mantle cell lymphoma (MCL) is an aggressive subtype of non-Hodgkin lymphoma characterized by overexpression of cyclin-D1. We investigated the effect of cyproheptadine alone and in combination with the proteasome inhibitor bortezomib in models of MCL. The combination of these drugs was mathematically synergistic, producing significant reductions in the mitochondrial membrane potential leading to apoptosis. In a severe combined immunodeficient beige mouse model, cyproheptadine plus bortezomib demonstrated a statistically significant advantage compared to either agent alone.
Re: Claritin (loratadine), Neupogen & Periactin
Can I take Advil for bone pain as a result of Neupogen shots?
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ethomas - Name: Emmanouel Thomas AKA Amo
- Who do you know with myeloma?: Yes
- When were you/they diagnosed?: August 14, 2014
- Age at diagnosis: 65
Re: Claritin (loratadine), Neupogen & Periactin (cyproheptad
Hello ethomas,
Ibuprofen (Advil) is one of the pain relievers that doctors often say you should be careful about taking if you are a multiple myeloma patient, especially if you've had some kidney damage. Apparently, it can damage your kidneys, especially if you take high doses of it.
Both Dr. Valent and Dr. Voorhees, who post here in the forum, mention this in postings they make a separate forum discussion about Neupogen and bone pain:
https://myelomabeacon.org/forum/neupogen-and-bone-pain-sct-prep-t2333.html
You may want to try other medications (except ibuprofen, Aspirin, or naproxen) for the pain, and contact your doctor to see what he or she recommends, before taking the ibuprofen.
Good luck!
Ibuprofen (Advil) is one of the pain relievers that doctors often say you should be careful about taking if you are a multiple myeloma patient, especially if you've had some kidney damage. Apparently, it can damage your kidneys, especially if you take high doses of it.
Both Dr. Valent and Dr. Voorhees, who post here in the forum, mention this in postings they make a separate forum discussion about Neupogen and bone pain:
https://myelomabeacon.org/forum/neupogen-and-bone-pain-sct-prep-t2333.html
You may want to try other medications (except ibuprofen, Aspirin, or naproxen) for the pain, and contact your doctor to see what he or she recommends, before taking the ibuprofen.
Good luck!
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