2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T907,Hand-foot syndrome (HFS) is a common dose-limiting toxic effect of several chemotherapy agents, particularly capecitabine. Despite its substantial impact on the patient's quality of life and potential to compromise therapeutic efficacy, effective preventive strategies remain limited. To evaluate and compare the efficacy of pharmacologic interventions for the prevention of chemotherapy-induced HFS through a network meta-analysis of published results of randomized clinical trials (RCTs). PubMed, Embase, and Cochrane CENTRAL were systematically searched from inception through November 2024 for relevant RCTs. Eligible studies were phase 2 or 3 RCTs that compared systemic or topical prophylactic interventions for the prevention of HFS. Data extraction was performed by 2 reviewers, and disagreements were resolved by consensus. Risk of bias was assessed using the Cochrane Risk of Bias tool. A frequentist random-effects network meta-analysis was conducted. The primary income was incidence of grade 2 or higher HFS. The secondary outcome was the incidence of any-grade HFS. Odds ratios (ORs) with 95% CIs were estimated. Ranking was assessed using P-scores and surface under the cumulative ranking (SUCRA) values. Nineteen RCTs were included, of which 17 trials comprising 2192 patients (median [range] age, 57 [56-61] years) were analyzed for the primary outcome. Compared with placebo, topical silymarin (OR, 0.08; 95% CI, 0.01-0.71), diclofenac (OR, 0.23; 95% CI, 0.08-0.62), 400-mg pyridoxine (OR, 0.28; 95% CI, 0.09-0.88), and celecoxib (OR, 0.41; 95% CI, 0.18-0.95) significantly reduced grade 2 or higher HFS. Diclofenac (OR, 0.30; 95% CI, 0.13-0.69) and celecoxib (OR, 0.46; 95% CI, 0.22-0.94) also reduced overall HFS incidence. In contrast, silymarin and 400-mg pyridoxine did not show benefit for overall HFS, while mapisal increased HFS risk (OR, 3.04; 95% CI, 1.07-8.64). Ranking analyses showed the highest SUCRA value for silymarin (0.91) and diclofenac (0.76). In this systematic review and network meta-analysis, diclofenac and silymarin were the most effective preventive strategies for HFS, with silymarin requiring confirmation in a larger randomized trial. Diclofenac emerged as the agent with the best overall supporting evidence, informed by both effect estimates and study quality.31:Te8e, Importance Hand-foot syndrome (HFS) is a common dose-limiting toxic effect of several chemotherapy agents, particularly capecitabine. Despite its substantial impact on the patient’s quality of life and potential to compromise therapeutic efficacy, effective preventive strategies remain limited. Objective To evaluate and compare the efficacy of pharmacologic interventions for the prevention of chemotherapy-induced HFS through a network meta-analysis of published results of randomized clinical trials (RCTs). Data Sources PubMed, Embase, and Cochrane CENTRAL were systematically searched from inception through November 2024 for relevant RCTs. Study Selection Eligible studies were phase 2 or 3 RCTs that compared systemic or topical prophylactic interventions for the prevention of HFS. Data Extraction and Synthesis Data extraction was performed by 2 reviewers, and disagreements were resolved by consensus. Risk of bias was assessed using the Cochrane Risk of Bias tool. A frequentist random-effects network meta-analysis was conducted. Main Outcomes and Measures The primary income was incidence of grade 2 or higher HFS. The secondary outcome was the incidence of any-grade HFS. Odds ratios (ORs) with 95% CIs were estimated. Ranking was assessed using P-scores and surface under the cumulative ranking (SUCRA) values. Results Nineteen RCTs were included, of which 17 trials comprising 2192 patients (median [range] age, 57 [56-61] years) were analyzed for the primary outcome. Compared with placebo, topical silymarin (OR, 0.08; 95% CI, 0.01-0.71), diclofenac (OR, 0.23; 95% CI, 0.08-0.62), 400-mg pyridoxine (OR, 0.28; 95% CI, 0.09-0.88), and celecoxib (OR, 0.41; 95% CI, 0.18-0.95) significantly reduced grade 2 or higher HFS. Diclofenac (OR, 0.30; 95% CI, 0.13-0.69) and celecoxib (OR, 0.46; 95% CI, 0.22-0.94) also reduced overall HFS incidence. In contrast, silymarin and 400-mg pyridoxine did not show benefit for overall HFS, while mapisal increased HFS risk (OR, 3.04; 95% CI, 1.07-8.64). Ranking analyses showed the highest SUCRA value for silymarin (0.91) and diclofenac (0.76). Conclusions and Relevance In this systematic review and network meta-analysis, diclofenac and silymarin were the most effective preventive strategies for HFS, with silymarin requiring confirmation in a larger randomized trial. Diclofenac emerged as the agent with the best overall supporting evidence, informed by both effect estimates and study quality. 32:T72c,This study aims to investigate the impact of non-steroidal anti-inflammatory drug (NSAID) intake on radiographic spinal progression in axial spondyloarthritis (axSpA), considering different NSAID types (COX-2 inhibitors [COX2i] and non-selective NSAIDs [ns-NSAIDs]) and disease subgroups (radiographic (r-axSpA) and non-radiographic (nr-axSpA). Leveraging data from the German Spondyloarthritis Inception Cohort (GESPIC), we conducted analyses on 252 axSpA patients (139 nr- axSpA and 113 r-axSpA), who had minimum 2 sets of spinal radiographs. The outcome was progression in modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in 2-year intervals. We fitted sequential conditional mean models by utilizing generalized estimating equations and adjusting for longitudinal repeated measures of exposure and time-dependent confounders. We report β-coefficients with 95% confidence intervals (CIs) for outcome reflecting the progression in mSASSS per 10-point increase in NSAID intake score. At baseline, 201 (80.0%) patients were under NSAID treatment, with 46 (18%) taking COX2i and 156 (62%) ns-NSAIDs and mean total NSAID intake score was 38.3±35.5. A 10-point increase in NSAID intake score was associated with retardation of radiographic progression (β=-0.052, 95%CI: -0.097, -0.007), with this effect being most pronounced in r-axSpA patients (β=-0.077, 95%CI: -0.152, -0.003). COX2i showed a slightly lower point estimate (although not statistically significant) in progression compared to ns-NSAIDs among all axSpA patients (β= -0.061 and -0.045, respectively). Our findings suggest a beneficial effect of higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA. These findings may help inform therapeutic strategies, particularly in r-axSpA, while further research is needed for nr-axSpA.33:T9ad, Objectives This study aims to investigate the impact of non‐steroidal anti‐inflammatory drug (NSAID) intake on radiographic spinal progression in axial spondyloarthritis (axSpA), considering different NSAID types (COX‐2 inhibitors [COX2i] and non‐selective NSAIDs [ns‐NSAIDs]) and disease subgroups (radiographic (r‐axSpA) and non‐radiographic (nr‐axSpA). Methods Leveraging data from the German Spondyloarthritis Inception Cohort (GESPIC), we conducted analyses on 252 axSpA patients (139 nr‐ axSpA and 113 r‐axSpA), who had minimum 2 sets of spinal radiographs. The outcome was progression in modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) in 2‐year intervals. We fitted sequential conditional mean models by utilizing generalized estimating equations and adjusting for longitudinal repeated measures of exposure and time‐dependent confounders. We report β‐coefficients with 95% confidence intervals (CIs) for outcome reflecting the progression in mSASSS per 10‐point increase in NSAID intake score. Results At baseline, 201 (80.0%) patients were under NSAID treatment, with 46 (18%) taking COX2i and 156 (62%) ns‐NSAIDs and mean total NSAID intake score was 38.3±35.5. A 10‐point increase in NSAID intake score was associated with retardation of radiographic progression (β=‐0.052, 95%CI: ‐0.097, ‐0.007), with this effect being most pronounced in r‐axSpA patients (β=‐0.077, 95%CI: ‐0.152, ‐0.003). COX2i showed a slightly lower point estimate (although not statistically significant) in progression compared to ns‐NSAIDs among all axSpA patients (β= ‐0.061 and ‐0.045, respectively). Conclusions Our findings suggest a beneficial effect of higher NSAID intake, particularly COX2i, on slowing radiographic progression in axSpA. These findings may help inform therapeutic strategies, particularly in r‐axSpA, while further research is needed for nr‐axSpA. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"COX-2 Inhibitor: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on COX-2 Inhibitor (modality). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/modality/COX-2%20Inhibitor\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Modalities\",\"item\":\"https://www.reachrx.ai/hub/tag/modality\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"COX-2 Inhibitor\",\"item\":\"https://www.reachrx.ai/hub/tag/modality/COX-2%20Inhibitor\"}]}}"}}]],["$","$L2f",null,{"title":"COX-2 Inhibitor: Research & Clinical Takeaways","description":"Review evidence by treatment modality: COX-2 Inhibitor — concise summaries and practical next steps.","papers":[{"doi":"10.5435/jaaos-d-25-01556","pmid":"42212818","title":"Safety of Celecoxib in Postoperative Patients With Documented Sulfonamide Allergies","journal_title":"Journal of the American Academy of Orthopaedic Surgeons","journal_issn":"1067-151X","published_at":"2026-05-29T00:00:00.000Z","url":"https://doi.org/10.5435/jaaos-d-25-01556","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-06T13:23:00.382Z","updated_at":"2026-06-06T13:23:00.382Z","tags":[{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"brand","value":"Celebrex","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"condition","value":"Postoperative Pain","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"condition","value":"Sulfonamide Allergy","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"generic","value":"celecoxib","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"modality","value":"COX-2 Inhibitor","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"modality","value":"Nonsteroidal Anti-Inflammatory Drug","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"sample_size","value":"n=61","value_numeric":61},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"warning","value":"Follow-up duration was limited to approximately 49 days; longer-term reactions are not captured.","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"warning","value":"The brand name 'Celebrex' is inferred from the generic 'celecoxib' and is not explicitly mentioned in the abstract.","value_numeric":null},{"paper_doi":"10.5435/jaaos-d-25-01556","tag_type":"warning","value":"The study's small sample size (n=61) may be underpowered to detect rare allergic reactions; a true cross-reactivity rate could exist but go undetected.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study evaluated the safety of postoperative celecoxib in 61 orthopaedic surgery patients with documented sulfonamide allergies at a single tertiary academic center, from January 2020 to December 2022, with follow-up through the second postoperative visit (mean ~49 days).","key_result":"No allergic reactions were attributable to celecoxib in any of the 61 sulfa-allergic patients (0%). Two allergic reactions occurred but were traced to perioperative antibiotics or surgical adhesive; one patient (1.6%) had a GI bleed while concurrently taking aspirin.","limitations":"- Small single-center sample (n=61) limits generalizability.\n- Retrospective design with follow-up only through the second postoperative visit (~49 days); delayed reactions could be missed.\n- No control group of sulfa-allergic patients who did *not* receive celecoxib for comparison.","practice_takeaway":"Celecoxib appears safe to use in orthopaedic postoperative patients with documented sulfonamide allergies, with no cross-reactivity observed. Clinicians and health systems should consider updating EHR allergy alert logic to reduce unnecessary celecoxib avoidance and support multimodal pain management."}},{"doi":"10.1001/jamaneurol.2026.0230","pmid":"41837970","title":"Safety and Efficacy of PrimeC in Amyotrophic Lateral Sclerosis","journal_title":"JAMA Neurology","journal_issn":"2168-6149","published_at":"2026-03-16T00:00:00.000Z","url":"https://doi.org/10.1001/jamaneurol.2026.0230","source_score":163,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-18T13:25:21.564Z","updated_at":"2026-05-18T13:25:21.564Z","tags":[{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"brand","value":"PrimeC","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"condition","value":"Amyotrophic Lateral Sclerosis","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"generic","value":"celecoxib","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"generic","value":"ciprofloxacin","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"modality","value":"COX-2 Inhibitor","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"modality","value":"Fixed-Dose Combination Oral Therapy","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"modality","value":"Fluoroquinolone Antibiotic","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"sample_size","value":"n=68","value_numeric":68},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"warning","value":"The 18-month efficacy data derive from an open-label extension — the between-group comparison lacks a concurrent placebo arm at that timepoint, which materially limits causal inference.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"warning","value":"The full text pages appear to contain only metadata from an unrelated protocol document (DocuSign envelope); all clinical content was extracted from the abstract and results sections only.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.0230","tag_type":"warning","value":"The prespecified primary biomarker outcomes (neuron-derived exosome TDP-43 and prostaglandin J2) were not reported in this publication and will be reported separately, so the primary biomarker endpoint is incomplete.","value_numeric":null}],"summaries":{"what_studied":"A randomized, double-blind, placebo-controlled phase 2b trial (+ 12-month open-label extension) evaluated PrimeC — a fixed-dose oral combination of celecoxib and ciprofloxacin — for safety, tolerability, and potential efficacy in 68 adults with definite or probable ALS and disease duration ≤30 months, across 4 ALS referral centers (May 2022–November 2023), randomized 2:1 (PrimeC vs. placebo) for 6 months.","key_result":"PrimeC was well tolerated (AE rate 66.7% vs. 65.2% placebo); drug-related AEs were more common with PrimeC (20.0% vs. 4.3%) but mostly mild-to-moderate. The 6-month ALSFRS-R difference was 2.23 points (95% CI, −0.61 to 5.07; P = .12). At 18 months, continuously treated participants showed a 7.92-point ALSFRS-R advantage (95% CI, 2.25–13.60; P = .007) and a 3.18-point bulbar subscale advantage (P = .001). Continuous PrimeC reduced the composite risk of hospitalization, respiratory failure, or death by 64% (HR 0.36; 95% CI, 0.15–0.85; P = .02). ALS-associated microRNAs (miR-199a-3p/5p, miR-181a-5p/b-5p) were significantly downregulated, and iron-dysregulation biomarkers were favorably modulated.","limitations":"- Trial was not powered for efficacy; 6-month primary endpoint missed significance (P = .12), and 18-month functional gains come from an open-label extension with no concurrent placebo control.\n- Small sample size (n = 68) limits generalizability and increases risk of imbalance-driven effects.\n- Prespecified primary biomarker outcomes (neuron-derived exosome TDP-43/PgJ2) have not yet been reported.","practice_takeaway":"PrimeC (celecoxib + ciprofloxacin) appears safe over 18 months and showed functional and biomarker signals in ALS, but the trial was underpowered for efficacy — a confirmatory phase 3 trial is warranted before clinical adoption."}},{"doi":"10.1001/jamadermatol.2026.0042","pmid":"41779386","title":"Preventing Hand-Foot Syndrome in Patients With Cancer","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2026-03-04T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12961603/","source_score":33,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-19","doi":"10.1001/jamadermatol.2026.0042","days":"30","issn":"2168-6068","rank":"8","field":"Clinical Medicine","score":"33","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2026.0042","title":"Preventing Hand-Foot Syndrome in Patients With Cancer: A Systematic Review and Network Meta-Analysis.","journal":"JAMA dermatology","methods":"","results":"Nineteen RCTs were included, of which 17 trials comprising 2192 patients (median [range] age, 57 [56-61] years) were analyzed for the primary outcome. Compared with placebo, topical silymarin (OR, 0.08; 95% CI, 0.01-0.71), diclofenac (OR, 0.23; 95% CI, 0.08-0.62), 400-mg pyridoxine (OR, 0.28; 95% CI, 0.09-0.88), and celecoxib (OR, 0.41; 95% CI, 0.18-0.95) significantly reduced grade 2 or higher HFS. Diclofenac (OR, 0.30; 95% CI, 0.13-0.69) and celecoxib (OR, 0.46; 95% CI, 0.22-0.94) also reduced overall HFS incidence. In contrast, silymarin and 400-mg pyridoxine did not show benefit for overall HFS, while mapisal increased HFS risk (OR, 3.04; 95% CI, 1.07-8.64). Ranking analyses showed the highest SUCRA value for silymarin (0.91) and diclofenac (0.76).","abstract":"$30","keywords":[],"pubmed_id":"41779386","conclusions":"","publication_date":"2026-03-04T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2026.0042","URL":"https://doi.org/10.1001/jamadermatol.2026.0042","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2845560/jamadermatology_baskarane_2026_oi_260002_1775760776.72378.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"386","type":"journal-article","issue":"4","score":1,"title":["Preventing Hand-Foot Syndrome in Patients With Cancer"],"author":[{"given":"Hemavathi","family":"Baskarane","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Shubham","family":"Sahni","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Chitrakshi","family":"Nagpal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Mohit Kumar","family":"Divakar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Neha","family":"Pathak","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Sudhir","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Sameer","family":"Bakhshi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Hari Krishna Raju","family":"Sagiraju","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Pranav Pratap","family":"Singh","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Rishika","family":"Agarwal","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Vishakha","family":"Hooda","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Payal","family":"Vasudeva","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]},{"given":"Atul","family":"Batra","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India"}]}],"issued":{"date-parts":[[2026,4,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"162","created":{"date-time":"2026-03-04T16:30:40Z","timestamp":1772641840000,"date-parts":[[2026,3,4]]},"indexed":{"date-time":"2026-04-15T15:51:16Z","timestamp":1776268276641,"date-parts":[[2026,4,15]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamadermatology/fullarticle/2845560"}},"subtitle":["A Systematic Review and Network Meta-Analysis"],"deposited":{"date-time":"2026-04-15T15:00:25Z","timestamp":1776265225000,"date-parts":[[2026,4,15]]},"issn-type":[{"type":"print","value":"2168-6068"}],"published":{"date-parts":[[2026,4,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1002/jgm.3289","key":"doi260002r1","year":"2021","issue":"1","author":"Naushad","volume":"23","first-page":null,"unstructured":null,"article-title":"Pharmacogenetic profiling of dihydropyrimidine dehydrogenase (DPYD) variants in the Indian population.","journal-title":"J Gene Med","doi-asserted-by":"publisher"},{"DOI":null,"key":"doi260002r2","year":"2006","issue":"5","author":"Janusch","volume":"16","first-page":"494","unstructured":null,"article-title":"The hand-foot syndrome–a frequent secondary manifestation in antineoplastic chemotherapy.","journal-title":"Eur J Dermatol","doi-asserted-by":null},{"DOI":"10.3332/ecancer.2022.1390","key":"doi260002r3","year":"2022","issue":null,"author":"de Queiroz","volume":"16","first-page":"1390","unstructured":null,"article-title":"Hand-foot syndrome caused by capecitabine: incidence, risk factors and the role of dermatological evaluation.","journal-title":"Ecancermedicalscience","doi-asserted-by":"publisher"},{"DOI":"10.4081/oncol.2020.442","key":"doi260002r4","year":"2020","issue":"1","author":"Kwakman","volume":"14","first-page":"442","unstructured":null,"article-title":"Management of cytotoxic chemotherapy-induced hand-foot syndrome.","journal-title":"Oncol Rev","doi-asserted-by":"publisher"},{"DOI":"10.7759/cureus.969","key":"doi260002r5","year":"2017","issue":"1","author":"Cohen","volume":"9","first-page":null,"unstructured":null,"article-title":"Capecitabine-associated loss of fingerprints: report of capecitabine-induced adermatoglyphia in two women with breast cancer and review of acquired dermatoglyphic absence in oncology patients treated with capecitabine.","journal-title":"Cureus","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1612645","key":"doi260002r6","year":"2017","issue":"22","author":"Masuda","volume":"376","first-page":"2147","unstructured":null,"article-title":"Adjuvant capecitabine for breast cancer after preoperative chemotherapy.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(11)61873-4","key":"doi260002r7","year":"2012","issue":"9813","author":"Bang","volume":"379","first-page":"315","unstructured":null,"article-title":"Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial.","journal-title":"Lancet","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa1713709","key":"doi260002r8","year":"2018","issue":"13","author":"Grothey","volume":"378","first-page":"1177","unstructured":null,"article-title":"Duration of adjuvant chemotherapy for stage III colon cancer.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMoa064320","key":"doi260002r9","year":"2006","issue":"26","author":"Geyer","volume":"355","first-page":"2733","unstructured":null,"article-title":"Lapatinib plus capecitabine for HER2-positive advanced breast cancer.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1634/theoncologist.2011-0033","key":"doi260002r10","year":"2011","issue":"10","author":"Sibaud","volume":"16","first-page":"1469","unstructured":null,"article-title":"HFS-14, a specific quality of life scale developed for patients suffering from hand-foot syndrome.","journal-title":"Oncologist","doi-asserted-by":"publisher"},{"DOI":"10.1093/annonc/mdg500","key":"doi260002r11","year":"2003","issue":"12","author":"Scheithauer","volume":"14","first-page":"1735","unstructured":null,"article-title":"Oral capecitabine as an alternative to IV 5-fluorouracil-based adjuvant therapy for colon cancer: safety results of a randomized, phase III trial.","journal-title":"Ann Oncol","doi-asserted-by":"publisher"},{"DOI":"10.3393/jksc.2010.26.4.287","key":"doi260002r12","year":"2010","issue":"4","author":"Yun","volume":"26","first-page":"287","unstructured":null,"article-title":"Oncologic outcome after cessation or dose reduction of capecitabine in patients with colon cancer.","journal-title":"J Korean Soc Coloproctol","doi-asserted-by":"publisher"},{"DOI":"10.1200/OA-24-00068","key":"doi260002r13","year":"2025","issue":"1","author":"Khan","volume":"2","first-page":null,"unstructured":null,"article-title":"Randomized trial of fixed-dose capecitabine compared with standard-dose capecitabine in metastatic breast cancer: X-7/7 trial.","journal-title":"JCO Oncol Adv","doi-asserted-by":"publisher"},{"DOI":"10.1186/s12885-022-10026-3","key":"doi260002r14","year":"2022","issue":"1","author":"Jiang","volume":"22","first-page":"950","unstructured":null,"article-title":"Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.","journal-title":"BMC Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1021/acs.chemrestox.6b00215","key":"doi260002r16","year":"2016","issue":"10","author":"Lou","volume":"29","first-page":"1591","unstructured":null,"article-title":"Possible pathways of capecitabine-induced hand-foot syndrome.","journal-title":"Chem Res Toxicol","doi-asserted-by":"publisher"},{"DOI":"10.1139/cjpp-2022-0439","key":"doi260002r17","year":"2023","issue":"7","author":"Mashaly","volume":"101","first-page":"340","unstructured":null,"article-title":"Thymidine phosphorylase as a molecular target for quercetin-incorporated collagen matrix in the prevention of hand-foot syndrome induced by capecitabine in rats.","journal-title":"Can J Physiol Pharmacol","doi-asserted-by":"publisher"},{"DOI":"10.1038/s41416-022-02039-3","key":"doi260002r18","year":"2023","issue":"2","author":"Yang","volume":"128","first-page":"219","unstructured":null,"article-title":"Capecitabine induces hand-foot syndrome through elevated thymidine phosphorylase-mediated locoregional toxicity and GSDME-driven pyroptosis that can be relieved by tipiracil.","journal-title":"Br J Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1007/s13577-012-0057-0","key":"doi260002r19","year":"2013","issue":"1","author":"Yokomichi","volume":"26","first-page":"8","unstructured":null,"article-title":"Pathogenesis of hand-foot syndrome induced by PEG-modified liposomal doxorubicin.","journal-title":"Hum Cell","doi-asserted-by":"publisher"},{"DOI":null,"key":"doi260002r20","year":"2009","issue":"6","author":"Martschick","volume":"29","first-page":"2307","unstructured":null,"article-title":"The pathogenetic mechanism of anthracycline-induced palmar-plantar erythrodysesthesia.","journal-title":"Anticancer Res","doi-asserted-by":null},{"DOI":"10.3727/096504018X15291727589740","key":"doi260002r21","year":"2019","issue":"5","author":"Nonomiya","volume":"27","first-page":"551","unstructured":null,"article-title":"Regorafenib-induced hand-foot skin reaction is more severe on the feet than on the hands.","journal-title":"Oncol Res","doi-asserted-by":"publisher"},{"DOI":"10.1080/02841860701765675","key":"doi260002r22","year":"2008","issue":"2","author":"Chu","volume":"47","first-page":"176","unstructured":null,"article-title":"Risk of hand-foot skin reaction with sorafenib: a systematic review and meta-analysis.","journal-title":"Acta Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1093/annonc/mdn389","key":"doi260002r23","year":"2008","issue":"11","author":"Lacouture","volume":"19","first-page":"1955","unstructured":null,"article-title":"Hand foot skin reaction in cancer patients treated with the multikinase inhibitors sorafenib and sunitinib.","journal-title":"Ann Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1634/theoncologist.2008-0131","key":"doi260002r24","year":"2008","issue":"9","author":"Lacouture","volume":"13","first-page":"1001","unstructured":null,"article-title":"Evolving strategies for the management of hand-foot skin reaction associated with the multitargeted kinase inhibitors sorafenib and sunitinib.","journal-title":"Oncologist","doi-asserted-by":"publisher"},{"DOI":"10.1111/j.1365-2125.2008.03159.x","key":"doi260002r25","year":"2008","issue":"1","author":"Milano","volume":"66","first-page":"88","unstructured":null,"article-title":"Candidate mechanisms for capecitabine-related hand-foot syndrome.","journal-title":"Br J Clin Pharmacol","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jaad.2014.03.019","key":"doi260002r26","year":"2014","issue":"4","author":"Miller","volume":"71","first-page":"787","unstructured":null,"article-title":"Chemotherapy-induced hand-foot syndrome and nail changes: a review of clinical presentation, etiology, pathogenesis, and management.","journal-title":"J Am Acad Dermatol","doi-asserted-by":"publisher"},{"DOI":"10.1021/acs.chemrestox.1c00317","key":"doi260002r27","year":"2022","issue":"3","author":"He","volume":"35","first-page":"422","unstructured":null,"article-title":"P38 MAPK, NF-?B, and JAK-STAT3 signaling pathways involved in capecitabine-induced hand-foot syndrome via interleukin 6 or interleukin 8 abnormal expression.","journal-title":"Chem Res Toxicol","doi-asserted-by":"publisher"},{"DOI":"10.1007/s00520-018-4054-z","key":"doi260002r28","year":"2018","issue":"7","author":"Bun","volume":"26","first-page":"2161","unstructured":null,"article-title":"Symptom management: the utility of regional cooling for hand-foot syndrome induced by pegylated liposomal doxorubicin in ovarian cancer.","journal-title":"Support Care Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.ygyno.2007.10.021","key":"doi260002r29","year":"2008","issue":"2","author":"Mangili","volume":"108","first-page":"332","unstructured":null,"article-title":"Prevention strategies in palmar-plantar erythrodysesthesia onset: the role of regional cooling.","journal-title":"Gynecol Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1002/cncr.23333","key":"doi260002r30","year":"2008","issue":"7","author":"Scotté","volume":"112","first-page":"1625","unstructured":null,"article-title":"Matched case-control phase 2 study to evaluate the use of a frozen sock to prevent docetaxel-induced onycholysis and cutaneous toxicity of the foot.","journal-title":"Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1093/annonc/mdr400","key":"doi260002r31","year":"2012","issue":"5","author":"Zhang","volume":"23","first-page":"1348","unstructured":null,"article-title":"Celecoxib can prevent capecitabine-related hand-foot syndrome in stage II and III colorectal cancer patients: result of a single-center, prospective randomized phase III trial.","journal-title":"Ann Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.23.01730","key":"doi260002r32","year":"2024","issue":"15","author":"Santhosh","volume":"42","first-page":"1821","unstructured":null,"article-title":"Topical diclofenac for prevention of capecitabine-associated hand-foot syndrome: a double-blind randomized controlled trial.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1136/spcare-2022-004011","key":"doi260002r33","year":"2024","issue":"e2","author":"Ramasubbu","volume":"14","first-page":"e1575","unstructured":null,"article-title":"Chemotherapy-induced hand foot syndrome: comparative efficacy and safety of pharmacological prophylaxis – systematic review and Bayesian network meta-analysis.","journal-title":"BMJ Support Palliat Care","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamaoncol.2017.1269","key":"doi260002r34","year":"2017","issue":"11","author":"Yap","volume":"3","first-page":"1538","unstructured":null,"article-title":"Predictors of hand-foot syndrome and pyridoxine for prevention of capecitabine-induced hand-foot syndrome: a randomized clinical trial.","journal-title":"JAMA Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.2014.60.4587","key":"doi260002r35","year":"2015","issue":"22","author":"Hofheinz","volume":"33","first-page":"2444","unstructured":null,"article-title":"Mapisal versus urea cream as prophylaxis for capecitabine-associated hand-foot syndrome: a randomized phase III trial of the AIO quality of life working group.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.2010.31.1431","key":"doi260002r36","year":"2010","issue":"35","author":"Wolf","volume":"28","first-page":"5182","unstructured":null,"article-title":"Placebo-controlled trial to determine the effectiveness of a urea/lactic acid-based topical keratolytic agent for prevention of capecitabine-induced hand-foot syndrome: North Central Cancer Treatment Group Study.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1002/cncr.25262","key":"doi260002r37","year":"2010","issue":"20","author":"von Gruenigen","volume":"116","first-page":"4735","unstructured":null,"article-title":"A double-blind, randomized trial of pyridoxine versus placebo for the prevention of pegylated liposomal doxorubicin-related hand-foot syndrome in gynecologic oncology patients.","journal-title":"Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1111/j.1743-7563.2010.01311.x","key":"doi260002r38","year":"2010","issue":"3","author":"Chalermchai","volume":"6","first-page":"155","unstructured":null,"article-title":"Randomized trial of two different doses of pyridoxine in the prevention of capecitabine-associated palmar-plantar erythrodysesthesia.","journal-title":"Asia Pac J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1200/JCO.2010.29.1807","key":"doi260002r39","year":"2010","issue":"24","author":"Kang","volume":"28","first-page":"3824","unstructured":null,"article-title":"Pyridoxine is not effective to prevent hand-foot syndrome associated with capecitabine therapy: results of a randomized, double-blind, placebo-controlled study.","journal-title":"J Clin Oncol","doi-asserted-by":"publisher"},{"DOI":"10.31557/APJCP.2024.25.6.2203","key":"doi260002r40","year":"2024","issue":"6","author":"Wanichtanom","volume":"25","first-page":"2203","unstructured":null,"article-title":"A randomized single-blinded phase II trial comparing efficacy and quality of life of topical aloe vera gel plus urea cream versus urea cream alone for prevention of hand foot syndrome in cancer patients receiving capecitabine.","journal-title":"Asian Pac J Cancer Prev","doi-asserted-by":"publisher"},{"DOI":"10.1002/ptr.5857","key":"doi260002r41","year":"2017","issue":"9","author":"Elyasi","volume":"31","first-page":"1323","unstructured":null,"article-title":"Topical silymarin administration for prevention of capecitabine-induced hand-foot syndrome: a randomized, double-blinded, placebo-controlled clinical trial.","journal-title":"Phytother Res","doi-asserted-by":"publisher"},{"DOI":"10.21037/apm-21-61","key":"doi260002r42","year":"2021","issue":"3","author":"Lu","volume":"10","first-page":"3009","unstructured":null,"article-title":"The effectiveness of EVOSKIN Palm and sole moisturizing cream in treating capecitabine-associated hand-foot syndrome: a randomized double-blind clinical trial.","journal-title":"Ann Palliat Med","doi-asserted-by":"publisher"},{"DOI":"10.1007/s12664-020-01039-6","key":"doi260002r43","year":"2020","issue":"2","author":"Watanabe","volume":"39","first-page":"204","unstructured":null,"article-title":"The effect of TJ-28 (eppikajutsuto) on the prevention of hand-foot syndrome using Capecitabine for colorectal cancer: the Yokohama Clinical Oncology Group Study (YCOG1102).","journal-title":"Indian J Gastroenterol","doi-asserted-by":"publisher"},{"DOI":"10.1007/s12282-018-0879-z","key":"doi260002r44","year":"2018","issue":"6","author":"Toyama","volume":"25","first-page":"729","unstructured":null,"article-title":"A randomized phase II study evaluating pyridoxine for the prevention of hand-foot syndrome associated with capecitabine therapy for advanced or metastatic breast cancer.","journal-title":"Breast Cancer","doi-asserted-by":"publisher"},{"DOI":"10.12788/jcso.0017","key":"doi260002r45","year":"2014","issue":"2","author":"Braik","volume":"12","first-page":"65","unstructured":null,"article-title":"Randomized trial of vitamin B6 for preventing hand-foot syndrome from capecitabine chemotherapy.","journal-title":"J Community Support Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1038/bjc.2012.318","key":"doi260002r46","year":"2012","issue":"4","author":"Corrie","volume":"107","first-page":"585","unstructured":null,"article-title":"A randomised study evaluating the use of pyridoxine to avoid capecitabine dose modifications.","journal-title":"Br J Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1177/15347354221140402","key":"doi260002r47","year":"2022","issue":null,"author":"Xiaozhe","volume":"21","first-page":null,"unstructured":null,"article-title":"Pyridoxine is effective for preventing hand-foot syndrome induced by pegylated liposomal doxorubicin for multiple myeloma: the results of a randomized study.","journal-title":"Integr Cancer Ther","doi-asserted-by":"publisher"},{"DOI":"10.5152/FNJN.2020.19097","key":"doi260002r48","year":"2020","issue":"3","author":"Kayikci","volume":"28","first-page":"299","unstructured":null,"article-title":"Henna Application in the prevention of capecitabine-induced hand-foot syndrome in breast and colorectal cancer patients.","journal-title":"Florence Nightingale J Nurs","doi-asserted-by":"publisher"},{"DOI":"10.1177/1534735420928466","key":"doi260002r49","year":"2020","issue":null,"author":"Yu","volume":"19","first-page":null,"unstructured":null,"article-title":"Effect of Chinese herbal compound LC09 on patients with capecitabine-associated hand-foot syndrome: a randomized, double-blind, and parallel-controlled trial.","journal-title":"Integr Cancer Ther","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.clbc.2022.01.009","key":"doi260002r50","year":"2022","issue":"5","author":"Xie","volume":"22","first-page":"e685","unstructured":null,"article-title":"Effect of a novel soaking solution used in patients with hand-foot syndrome as a result of capecitabine treatment: a randomized and self-controlled trial.","journal-title":"Clin Breast Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1002/ptr.5704","key":"doi260002r51","year":"2016","issue":"11","author":"Elyasi","volume":"30","first-page":"1879","unstructured":null,"article-title":"Effect of oral silymarin administration on prevention of radiotherapy induced mucositis: a randomized, double-blinded, placebo-controlled clinical trial.","journal-title":"Phytother Res","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.phymed.2009.02.002","key":"doi260002r52","year":"2009","issue":"5","author":"El-Kamary","volume":"16","first-page":"391","unstructured":null,"article-title":"A randomized controlled trial to assess the safety and efficacy of silymarin on symptoms, signs and biomarkers of acute hepatitis.","journal-title":"Phytomedicine","doi-asserted-by":"publisher"},{"DOI":"10.1016/S0923-7534(20)33033-7","key":"doi260002r53","year":"2012","issue":null,"author":"Altaei","volume":"23","first-page":"ix163","unstructured":null,"article-title":"Treatment of chemotherapy-induced oral mucositis by silymarin.","journal-title":"Ann Oncol","doi-asserted-by":"publisher"},{"DOI":"10.1002/ptr.6231","key":"doi260002r54","year":"2019","issue":"2","author":"Karbasforooshan","volume":"33","first-page":"379","unstructured":null,"article-title":"Topical silymarin administration for prevention of acute radiodermatitis in breast cancer patients: a randomized, double-blind, placebo-controlled clinical trial.","journal-title":"Phytother Res","doi-asserted-by":"publisher"},{"DOI":"10.1186/s12885-025-13684-1","key":"doi260002r55","year":"2025","issue":"1","author":"Wongkraisri","volume":"25","first-page":"275","unstructured":null,"article-title":"Randomized controlled trial on the efficacy of topical urea-based cream in preventing capecitabine-associated hand-foot syndrome.","journal-title":"BMC Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1007/s00520-022-07175-3","key":"doi260002r56","year":"2022","issue":"11","author":"Pandy","volume":"30","first-page":"8655","unstructured":null,"article-title":"Prophylactic strategies for hand-foot syndrome/skin reaction associated with systemic cancer treatment: a meta-analysis of randomized controlled trials.","journal-title":"Support Care Cancer","doi-asserted-by":"publisher"},{"DOI":"10.1186/s12891-025-08465-7","key":"doi260002r57","year":"2025","issue":"1","author":"Chen","volume":"26","first-page":"230","unstructured":null,"article-title":"Efficacy and safety of different topical diclofenac formulations for the treatment of knee osteoarthritis: a meta-analysis of short-term and long-term treatment comparisons.","journal-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher"},{"DOI":"10.1007/s40744-020-00196-6","key":"doi260002r58","year":"2020","issue":"2","author":"Bariguian Revel","volume":"7","first-page":"217","unstructured":null,"article-title":"Topical diclofenac, an efficacious treatment for osteoarthritis: a narrative review.","journal-title":"Rheumatol Ther","doi-asserted-by":"publisher"},{"DOI":"10.2147/CIA.S35416","key":"doi260002r59","year":"2012","issue":null,"author":"Peniston","volume":"7","first-page":"517","unstructured":null,"article-title":"Long-term tolerability of topical diclofenac sodium 1% gel for osteoarthritis in seniors and patients with comorbidities.","journal-title":"Clin Interv Aging","doi-asserted-by":"publisher"},{"DOI":"10.1007/s40122-025-00723-9","key":"doi260002r60","year":"2025","issue":"3","author":"Sicignano","volume":"14","first-page":"1007","unstructured":null,"article-title":"Evaluating the real-world use of topical diclofenac sodium gel 1% using US longitudinal electronic health records database: a study supporting OTC switch.","journal-title":"Pain Ther","doi-asserted-by":"publisher"},{"DOI":"10.1002/cpt.911","key":"doi260002r61","year":"2018","issue":"2","author":"Amstutz","volume":"103","first-page":"210","unstructured":null,"article-title":"Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for dihydropyrimidine dehydrogenase genotype and fluoropyrimidine dosing: 2017 update.","journal-title":"Clin Pharmacol Ther","doi-asserted-by":"publisher"},{"DOI":"10.1038/s41416-024-02754-z","key":"doi260002r62","year":"2024","issue":"3","author":"Chan","volume":"131","first-page":"498","unstructured":null,"article-title":"DPYD genetic polymorphisms in non-European patients with severe fluoropyrimidine-related toxicity: a systematic review.","journal-title":"Br J Cancer","doi-asserted-by":"publisher"},{"DOI":null,"key":"doi260002r15","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"National Cancer Institute, National Institutes of Health, US Department of Health and Human Services. Common Terminology Criteria for Adverse Events (CTCAE), version 6. Accessed June 17, 2025. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/ctc.htm","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1200/JCO.2016.34.15_suppl.e13018","key":"doi260002r63","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Peoples? AM, Ahmed? G, Galiauskas? R, . Polymorphisms in TPMT and TYMS may predict severe toxicity in DPYD wild-type patients receiving fluoropyrimidine (FP) chemotherapy for colorectal cancer. J Clin Oncol. 2016;34:e13018. doi:10.1200/JCO.2016.34.15_suppl.e13018","article-title":null,"journal-title":null,"doi-asserted-by":"crossref"}],"short-title":[],"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Dermatology"],"published-print":{"date-parts":[[2026,4,1]]},"reference-count":63,"published-online":null,"references-count":63,"short-container-title":["JAMA Dermatol"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1001/jamadermatol.2026.0042","is_oa":true,"title":"Preventing Hand-Foot Syndrome in Patients With Cancer","updated":"2026-03-07T18:31:02+00:00","published_date":"2026-03-04","best_oa_location":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12961603/","pmh_id":"oai:pubmedcentral.nih.gov:12961603","url_for_pdf":null,"url_for_landing_page":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12961603/"}}},"created_at":"2026-05-07T17:34:02.008Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"condition","value":"Hand-Foot Syndrome","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"generic","value":"capecitabine","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"generic","value":"celecoxib","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"generic","value":"diclofenac","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"generic","value":"mapisal","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"generic","value":"pyridoxine","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"generic","value":"silymarin","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"modality","value":"Antioxidant","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"modality","value":"COX-2 Inhibitor","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"modality","value":"Topical Anti-Inflammatory","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"modality","value":"Vitamin B6 Supplement","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"sample_size","value":"n=2192","value_numeric":2192},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"study_design","value":"Systematic Review and Network Meta-Analysis","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"warning","value":"Full text is under PMC embargo until March 2027; summary is based solely on the abstract and results excerpt provided.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"warning","value":"Sex distribution across trials is not explicitly reported in the abstract; 'mixed' is assumed based on cancer population context.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"warning","value":"Silymarin's exceptionally low OR (0.08) should be interpreted cautiously given it derives from a single small trial—the authors themselves call for confirmatory RCT evidence.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2026.0042","tag_type":"warning","value":"The impact_flag 'practice_changing' and 'safety_signal' are both tagged: practice_changing for diclofenac's evidence base, and safety_signal for mapisal's unexpected harm signal.","value_numeric":null}],"summaries":{"what_studied":"This network meta-analysis of 19 RCTs (17 contributing to the primary outcome; n=2,192 patients; median age 57 years) evaluated pharmacologic interventions—topical and systemic—for preventing chemotherapy-induced hand-foot syndrome (HFS), primarily from capecitabine.","key_result":"Compared with placebo, topical silymarin (OR 0.08), diclofenac (OR 0.23), high-dose pyridoxine 400 mg (OR 0.28), and celecoxib (OR 0.41) each significantly reduced grade ≥2 HFS. Diclofenac had the broadest evidence, reducing both grade ≥2 and any-grade HFS (OR 0.30). Notably, mapisal *increased* HFS risk (OR 3.04). Silymarin ranked highest by SUCRA (0.91) but rests on limited trial data.","limitations":"- Silymarin's strong effect estimate comes from a single small trial and needs confirmation in a larger RCT.\n- Network meta-analysis relies on indirect comparisons; heterogeneity across trials in HFS grading and chemotherapy regimens may affect estimates.\n- Median age range is narrow (56–61 years), limiting generalizability to older or pediatric populations.","practice_takeaway":"For patients starting capecitabine, topical diclofenac has the strongest overall evidence for preventing clinically significant (grade ≥2) HFS and should be considered as a prophylactic option. Avoid mapisal, which was associated with *increased* HFS risk in this analysis."}},{"doi":"10.1002/art.43447","pmid":"41310944","title":"The impact of non‐steroidal anti‐inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10‐year results from an inception cohort","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2025-11-28T00:00:00.000Z","url":"https://doi.org/10.1002/art.43447","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-03","doi":"10.1002/art.43447","days":"7","issn":"2326-5191","rank":"8","field":"Clinical Medicine","score":"7","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/art.43447","title":"The impact of non-steroidal anti-inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10-year results from an inception cohort.","journal":"Arthritis & rheumatology (Hoboken, N.J.)","methods":"","results":"At baseline, 201 (80.0%) patients were under NSAID treatment, with 46 (18%) taking COX2i and 156 (62%) ns-NSAIDs and mean total NSAID intake score was 38.3±35.5. A 10-point increase in NSAID intake score was associated with retardation of radiographic progression (β=-0.052, 95%CI: -0.097, -0.007), with this effect being most pronounced in r-axSpA patients (β=-0.077, 95%CI: -0.152, -0.003). COX2i showed a slightly lower point estimate (although not statistically significant) in progression compared to ns-NSAIDs among all axSpA patients (β= -0.061 and -0.045, respectively).","abstract":"$32","keywords":[],"pubmed_id":"41310944","conclusions":"","publication_date":"2025-11-28T00:00:00"},"crossref":{"DOI":"10.1002/art.43447","URL":"https://doi.org/10.1002/art.43447","ISSN":["2326-5191","2326-5205"],"link":[{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/art.43447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["The impact of non‐steroidal anti‐inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10‐year results from an inception cohort"],"author":[{"given":"Murat","family":"Torgutalp","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Department of Rheumatology and Clinical Immunology, Charité ‐ Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP Berlin Germany"},{"name":"Institute of Public Health Charité ‐ Universitätsmedizin Berlin Berlin Germany"}]},{"given":"Valeria","family":"Rios Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Fabian","family":"Proft","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Mikhail","family":"Protopopov","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Judith","family":"Rademacher","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Berlin Institute of Health at Charité Universitätsmedizin Berlin Berlin Germany"}]},{"given":"Hildrun","family":"Haibel","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Joachim","family":"Sieper","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"}]},{"given":"Martin","family":"Rudwaleit","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Rheumatology, Klinikum Bielefeld Rosenhöhe Bielefeld Germany"}]},{"given":"Denis","family":"Poddubnyy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin Germany"},{"name":"Division of Rheumatology, University of Toronto and Schroeder Arthritis Institute University Health Network Toronto Ontario Canada"}]}],"issued":{"date-parts":[[2025,11,27]]},"member":"311","prefix":"10.1002","source":"Crossref","volume":null,"archive":["Portico"],"created":{"date-time":"2025-11-28T05:29:22Z","timestamp":1764307762000,"date-parts":[[2025,11,28]]},"indexed":{"date-time":"2025-11-28T05:32:07Z","timestamp":1764307927013,"date-parts":[[2025,11,28]]},"license":[{"URL":"http://creativecommons.org/licenses/by/4.0/","start":{"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000,"date-parts":[[2025,11,27]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":"$33","language":"en","relation":{},"resource":{"primary":{"URL":"https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.43447"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-05-29"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2025-10-10"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2025-11-27"}],"deposited":{"date-time":"2025-11-28T05:29:23Z","timestamp":1764307763000,"date-parts":[[2025,11,28]]},"issn-type":[{"type":"print","value":"2326-5191"},{"type":"electronic","value":"2326-5205"}],"published":{"date-parts":[[2025,11,27]]},"publisher":"Wiley","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1002/crossmark_policy","alternative-id":["10.1002/art.43447"],"article-number":"art.43447","content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"original-title":[],"container-title":["Arthritis & Rheumatology"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2025,11,27]]},"references-count":0,"short-container-title":["Arthritis & Rheumatology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1002/art.43447","is_oa":true,"title":"The impact of non‐steroidal anti‐inflammatory drugs on radiographic spinal progression in patients with axial spondyloarthritis: 10‐year results from an inception cohort","updated":"2025-11-29T00:16:09+00:00","published_date":"2025-11-27","best_oa_location":{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/art.43447","pmh_id":null,"url_for_pdf":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/art.43447","url_for_landing_page":"https://doi.org/10.1002/art.43447"}}},"created_at":"2025-12-08T12:24:58.509Z","updated_at":"2025-12-08T12:24:58.509Z","tags":[{"paper_doi":"10.1002/art.43447","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"modality","value":"COX-2 Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"modality","value":"NSAID","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"sample_size","value":"n=252","value_numeric":252},{"paper_doi":"10.1002/art.43447","tag_type":"study_design","value":"Cohort","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"warning","value":"Effect sizes are reported per 10-point increase in an NSAID intake score; the scale’s clinical meaning is not described here.","value_numeric":null},{"paper_doi":"10.1002/art.43447","tag_type":"warning","value":"The COX-2 vs non-selective NSAID difference was not statistically significant; subtype comparisons should be interpreted cautiously.","value_numeric":null}],"summaries":{"what_studied":"A 10‑year analysis from the GESPIC inception cohort evaluated whether NSAID intake (COX‑2 inhibitors vs non‑selective NSAIDs) affects radiographic spinal progression in axial spondyloarthritis, using mSASSS scored every 2 years in 252 patients (139 nr‑axSpA; 113 r‑axSpA).","key_result":"Each 10‑point increase in NSAID intake score was associated with less mSASSS progression (β = −0.052; 95% CI −0.097 to −0.007), with a larger effect in r‑axSpA (β = −0.077; 95% CI −0.152 to −0.003). COX‑2 inhibitors had a slightly lower (not statistically significant) point estimate vs non‑selective NSAIDs (β −0.061 vs −0.045); at baseline, 201/252 (80%) used NSAIDs (46 COX2i; 156 ns‑NSAIDs).","limitations":"Inception cohort (non‑randomized). The COX‑2 vs non‑selective NSAID comparison was not statistically significant.","practice_takeaway":"Higher NSAID intake was associated with slower radiographic spinal progression, especially in radiographic axSpA; this may inform discussions about sustained NSAID use for structural outcomes. Evidence does not support preferring COX‑2 inhibitors over non‑selective NSAIDs for this purpose."}}],"initialOffset":4,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"COX-2 Inhibitor"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"COX-2 Inhibitor"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"COX-2 Inhibitor"}}}]]

Papers