School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, UK.
Palliat Med. 2012 Jan;26(1):50-60. doi: 10.1177/0269216311418869. Epub 2011 Sep 21.
An examination of whether oxycodone/naloxone prolonged-release tablets (OXN PR) can improve constipation and maintain analgesia, compared with oxycodone prolonged-release tablets (OxyPR) in patients with moderate/severe cancer pain.
Randomized, double-blind, active-controlled, double-dummy, parallel-group study in which 185 patients were randomized to receive up to 120 mg/day of OXN PR or OxyPR over 4 weeks. Efficacy assessments included Bowel Function Index (BFI), Brief Pain Inventory Short-Form (BPI-SF), laxative and rescue medication use. Quality of life (QoL) and safety assessments were conducted.
After 4 weeks, mean BFI score was significantly lower with OXN PR; mean total laxative intake was 20% lower with OXN PR. Mean BPI-SF scores were similar for both treatments and the average rate of analgesic rescue medication use was low and comparable. QoL assessments were stable and comparable with greater improvements in constipation-specific QoL assessments with OXN PR. Overall, rates of adverse drug reactions were similar.
OXN PR provides superior bowel function in cancer pain patients, compared with OxyPR, without compromising analgesic efficacy or safety. This study confirms that OXN PR is well tolerated and efficacious in cancer pain patients and results are in line with those seen in non-malignant pain patients.
考察与盐酸羟考酮缓释片(OxyPR)相比,盐酸羟考酮/纳洛酮缓释片(OXN PR)能否改善中重度癌痛患者的便秘并维持镇痛效果。
这是一项随机、双盲、阳性对照、双模拟、平行分组研究,共纳入 185 例患者,随机接受 OXN PR(每日最高 120mg)或 OxyPR 治疗,疗程 4 周。疗效评估包括肠道功能指数(BFI)、简明疼痛量表短表(BPI-SF)、通便药物和解救药物的使用情况。同时还进行了生活质量(QoL)和安全性评估。
治疗 4 周后,OXN PR 组患者的 BFI 评分显著降低,平均总通便药物用量降低 20%。两种治疗的 BPI-SF 评分相似,平均镇痛解救药物使用率较低且相似。QoL 评估稳定且相似,OXN PR 组患者的便秘特异性 QoL 评估有更大改善。总体而言,药物不良反应发生率相似。
与 OxyPR 相比,OXN PR 可改善癌症疼痛患者的肠道功能,而不影响镇痛疗效和安全性。本研究证实,OXN PR 对癌症疼痛患者具有良好的耐受性和疗效,结果与非恶性疼痛患者的研究结果一致。