Development of New Guideline for the Theatment of Bone Cancer Pain.

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Non-steroidal anti-inflammatory drugs (NSAIDs) are clinically used for the treatment of bone cancer pain but the mechanisms NSAIDs use to produce an analgesic effect in patients with bone cancer pain are not fully understood. To explore the mechanisms NSAIDs use to produce an analgesic effect on bone cancer pain, the authors examined the effects of oral administration of a COX-1 selective inhibitor (SC560), a COX-2 selective inhibitor (celecoxib) and a non-selective 4 COX inhibitor (indomethacin) in a mouse bone cancer pain model and compared these effects to the effect of orally administered morphine. Recently, the third COX, COX-3, has been reported. Acetaminophen has been reported to be a selective COX-3 inhibitor. We also examined the effect of acetaminophen on bone cancer pain. Acetaminophen and indomethacin, but not of SC560 and celecoxib, produced an analgesic effect on bone cancer pain. Co-administration of sub-analgesic doses of morphine with acetaminophen enhanced an analgesic effect of acetaminophen. Our data suggested that the oral administration of acetaminophen, but not a COX-1 selective inhibitor and a COX-2 selective inhibitor, produces an analgesic effect on bone cancer pain. The co-administration of acetaminophen with an opioid provides a beneficial effect in the treatment of bone cancer pain.