Differences in the Analgesic Effect of Opioids on Pain in Cancer Patients With Spinal Metastases.
bone metastasis pain
cancer pain management
methadone
opioids
spinal metastasis
tapentadol
Journal
Palliative medicine reports
ISSN: 2689-2820
Titre abrégé: Palliat Med Rep
Pays: United States
ID NLM: 101770666
Informations de publication
Date de publication:
2023
2023
Historique:
accepted:
14
07
2023
medline:
28
8
2023
pubmed:
28
8
2023
entrez:
28
8
2023
Statut:
epublish
Résumé
Spinal metastasis pain includes both inflammatory and neuropathic pain, and opioids, which have only a μ-opioid receptor-stimulating effect, are generally less effective in neuropathic pain. However, no previous study has been conducted for the comparisons of the efficacy of opioids in treating spinal metastasis pain. To compare the efficacy of tapentadol and methadone with other opioids for back pain caused by a metastatic spinal tumor. Retrospective cohort study. A total of 274 patients were enrolled, who started a tapentadol extended-release tablet, methadone tablet, hydromorphone extended-release tablet, oxycodone extended-release tablet, or transdermal fentanyl patch for cancer pain due to spinal metastasis in Japan from January 1, 2013 to October 31, 2021. The primary endpoint, the difference in the numerical rating scale (NRS) scores before and seven days after each opioid administration, was compared among the five groups. In patients with numbness, a decrease of the NRS score on day seven compared with before starting each opioid was significantly higher in the tapentadol group than those in the hydromorphone, oxycodone, and fentanyl groups and comparable to that in the methadone group. In patients without numbness, no significant differences were observed in decreases of the NRS scores on day seven among the five groups. Tapentadol and methadone may be more effective than hydromorphone, oxycodone, and fentanyl for cancer pain due to spinal metastasis with numbness.
Sections du résumé
Background
UNASSIGNED
Spinal metastasis pain includes both inflammatory and neuropathic pain, and opioids, which have only a μ-opioid receptor-stimulating effect, are generally less effective in neuropathic pain. However, no previous study has been conducted for the comparisons of the efficacy of opioids in treating spinal metastasis pain.
Objective
UNASSIGNED
To compare the efficacy of tapentadol and methadone with other opioids for back pain caused by a metastatic spinal tumor.
Design
UNASSIGNED
Retrospective cohort study.
Setting/Subjects
UNASSIGNED
A total of 274 patients were enrolled, who started a tapentadol extended-release tablet, methadone tablet, hydromorphone extended-release tablet, oxycodone extended-release tablet, or transdermal fentanyl patch for cancer pain due to spinal metastasis in Japan from January 1, 2013 to October 31, 2021.
Measurements
UNASSIGNED
The primary endpoint, the difference in the numerical rating scale (NRS) scores before and seven days after each opioid administration, was compared among the five groups.
Results
UNASSIGNED
In patients with numbness, a decrease of the NRS score on day seven compared with before starting each opioid was significantly higher in the tapentadol group than those in the hydromorphone, oxycodone, and fentanyl groups and comparable to that in the methadone group. In patients without numbness, no significant differences were observed in decreases of the NRS scores on day seven among the five groups.
Conclusions
UNASSIGNED
Tapentadol and methadone may be more effective than hydromorphone, oxycodone, and fentanyl for cancer pain due to spinal metastasis with numbness.
Identifiants
pubmed: 37637760
doi: 10.1089/pmr.2023.0018
pii: 10.1089/pmr.2023.0018
pmc: PMC10457616
doi:
Types de publication
Journal Article
Langues
eng
Pagination
220-230Informations de copyright
© Miho Takemura et al., 2023; Published by Mary Ann Liebert, Inc.
Déclaration de conflit d'intérêts
No competing financial interests exist.
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