Mortimer, J.E., Lauman, M.K., Tan, B., Dempsey, C.L., Shillington, A.C., & Hutchins, K.S. (2003). Pyridoxine treatment and prevention of hand-and-foot syndrome in patients receiving capecitabine. Journal of Oncology Pharmacy Practice, 9, 161–166.

To evaluate the effectiveness of oral pyridoxine for preventing and treating palmar plantar erythrodysesthesia (PPE) associated with capecitabine

Of the patients receiving oral pyridoxine, 73 patients (74%) received it as prophylaxis, and the remainder (26%) received it as acute hand-foot syndrome (HFS) treatment. The median dose of pyridoxine was 200 mg/m².

• N = 198–99 patients who were receiving capecitabine and pyridoxine and 99 patients who were receiving capecitabine and no pyridoxine

• SITE: Multi-site
• SETTING TYPE: Outpatient centers
• LOCATION: Sentara Cancer Institute in Norfolk, VA

• Retrospective review of 198 charts

• National Cancer Institute Common Toxicity Criteria version 2.0

The data did not support that vitamin B₆ prophylaxis prevented overall PPE incidence in a greater proportion of patients compared with those who did not receive prophylaxis (60% versus 53%). However, when used as treatment, a greater proportion of patients receiving vitamin B₆ reported symptom improvement (65% versus 12%, p < 0.001).

Pyridoxine is not recommended for prophylaxis but may provide some relief for patients with acute HFS.

• The data was obtained from chart review, which is subject to documentation bias and patient selection.
• This was not a controlled trial.
• A controlled trial of Xeloda^® with and without vitamin B₆ seems warranted.