Schikowski Artur, Krings Doris, Schwenke Karla
Neurology and Specialist Pain Therapy, Specialist Center Düsseldorf, Düsseldorf, Germany.
Grünenthal GmbH, Aachen, Germany.
J Pain Res. 2014 Dec 22;8:1-8. doi: 10.2147/JPR.S72150. eCollection 2015.
Clinical trials have shown the efficacy and good tolerability of tapentadol prolonged release (PR) for severe chronic pain of different etiologies. This study investigated the influence of tapentadol PR on pain control and quality of life of patients with severe chronic cancer-related pain in routine clinical practice in Germany.
During a 3-month observation period, 45 physicians (mainly palliative care specialists) documented dosage and tolerability of tapentadol PR, previous and concomitant analgesic treatment, pain intensity, pain-related restrictions of daily activities and quality of life, and general state of health of 123 patients with chronic cancer-related pain in the context of a prospective noninterventional study.
All patients (mean age 63.9±13.2 years, 93.5% in constant pain) had received analgesic long-term treatment (42.3% strong opioids) prior to the start of tapentadol PR treatment. During the observation period, tapentadol PR significantly reduced the average pain intensity by 2.4 points (from a mean 6.1±1.7 to 3.7±2.0, P<0.001); half of the patients (52%) achieved a pain score ≤3 at the end of observation. At the same time, mental and emotional well-being, pain-related impairments of daily activities, sleep quality, and quality of life improved, while the overall intake of analgesic concomitant medication could be reduced. Improvements in general state of health were significant (P<0.001). Overall, tapentadol PR was well tolerated.
Good pain control with tapentadol PR was accompanied by markedly reduced pain-related mental and physical burden and quality of life improved. Overall, the general state of health of these patients with chronic cancer-related pain improved significantly despite the underlying illness.
临床试验已表明,曲马多缓释片(PR)对不同病因的重度慢性疼痛具有疗效且耐受性良好。本研究在德国的常规临床实践中,调查了曲马多缓释片对重度慢性癌痛患者疼痛控制及生活质量的影响。
在为期3个月的观察期内,45名医生(主要为姑息治疗专家)在一项前瞻性非干预性研究中,记录了123例慢性癌痛患者的曲马多缓释片剂量及耐受性、先前及同时使用的镇痛治疗、疼痛强度、与疼痛相关的日常活动受限情况、生活质量以及总体健康状况。
所有患者(平均年龄63.9±13.2岁,93.5%处于持续性疼痛中)在开始曲马多缓释片治疗前均接受过长期镇痛治疗(42.3%使用强阿片类药物)。在观察期内,曲马多缓释片使平均疼痛强度显著降低了2.4分(从平均6.1±1.7降至3.7±2.0,P<0.001);一半患者(52%)在观察期末疼痛评分≤3。与此同时,精神和情绪健康状况、与疼痛相关的日常活动障碍、睡眠质量及生活质量均有所改善,同时镇痛辅助药物的总体摄入量可减少。总体健康状况有显著改善(P<0.001)。总体而言,曲马多缓释片耐受性良好。
曲马多缓释片对疼痛的良好控制伴随着与疼痛相关的身心负担显著减轻,生活质量得到改善。总体而言,尽管患有基础疾病,但这些慢性癌痛患者的总体健康状况仍有显著改善。