Tapentadol prolonged release for patients with multiple myeloma suffering from moderate-to-severe cancer pain due to bone disease.
Tapentadol prolonged release for patients with multiple myeloma suffering from moderate-to-severe cancer pain due to bone disease.
复制标题
Tapentadol延长了多发性骨髓瘤患者的释放，患有中度到重度癌症由于骨骼疾病。
DOI：
10.2147/jpr.s83490
复制
发表时间：
2015
影响因子：
2.7
通讯作者：
Mattia C
中科院分区：
文献类型：
--
作者：
Coluzzi F;Raffa RB;Pergolizzi J;Rocco A;Locarini P;Cenfra N;Cimino G;Mattia C
骨髓瘤骨病（MBD）是多发性骨髓瘤的一种毁灭性并发症，会导致严重的疼痛。本研究的目的是评估他他多缓释（PR）治疗MBD患者中至重度癌性疼痛的疗效和耐受性。对25名opioid-naïve MBD患者进行了为期12周的前瞻性研究。患者最初接受每日两次的tapentadol PR 50mg。然后控制剂量以维持足够的缓解或剂量限制性毒性。每隔一周记录4周，然后在第8周和第12周记录以下参数：疼痛、阿片类药物相关不良反应、其他镇痛药的使用、DN4 （Douleur neuropathque 4）评分。在基线和最终评估时测量生活质量（SF-36[36项简短健康调查]）。在25名患者中，22名完成了研究。疼痛强度从基线到各周间隔均显著降低（P<0.01）。生活质量在SF-36各分量表参数上均有显著改善（P<0.01），身心状态均有显著改善（P<0.01）。Tapentadol PR可显著降低DN4平均值（P<0.01）和伴有神经性成分（DN4≥4）的患者数（P<0.01）。治疗8周后，所有患者DN4评分均为阴性。Tapentadol PR耐受性良好，研究期间减少了其他镇痛药的使用。对于中度至重度疼痛的opioid-naïve MBD患者，开始剂量为100mg /天的他他多尔PR是有效且耐受性良好的。他他多PR可以被认为是患有混合疼痛和神经性成分的癌症患者的首选阿片类药物。
Myeloma bone disease (MBD) is a devastating complication of multiple myeloma that leads to severe pain. The aim of this study was to evaluate the efficacy and tolerability of tapentadol prolonged release (PR) in the management of patients with MBD suffering from moderate-to-severe cancer pain. A 12-week prospective study was carried out in 25 opioid-naïve MBD patients. Patients initially received twice-daily doses of tapentadol PR 50 mg. Doses were then managed to maintain adequate relief or dose-limiting toxicity. The following parameters were recorded at weekly intervals for 4 weeks, and then at weeks 8 and 12: pain, opioid-related adverse effects, use of other analgesics, DN4 (Douleur Neuropathique 4) score. Quality of life (SF-36 [36-item short-form health survey]) was measured at baseline and at final evaluation. Of 25 patients, 22 completed the study. Pain intensity significantly decreased from baseline to all the week intervals (P<0.01). Quality of life significantly improved with respect to all SF-36 subscale parameters (P<0.01), and so did both the physical and mental status (P<0.01). Tapentadol PR significantly reduced DN4 mean value (P<0.01) and the number of patients with neuropathic component (DN4 ≥4) (P<0.01). After 8 weeks of treatment, all patients were negative for the DN4 score. Tapentadol PR was well tolerated, and the use of other analgesics was reduced during the study period. Tapentadol PR started in doses of 100 mg/day was effective and well tolerated in opioid-naïve MBD patients with moderate-to-severe pain. Tapentadol PR can be considered a first-choice opioid in cancer patients suffering from mixed pain with a neuropathic component.