Hesselbarth Sabine, Hermanns Kai, Oepen Petra
Regionales Schmerz- und PalliativZentrum DGS Mainz , Mainz, Rheinstraße 4 F/ Fort Malakoff, 55116 Mainz , Germany +49 6131 6693401 ; +49 6131 6693402 ;
Expert Opin Pharmacother. 2015 Mar;16(4):457-64. doi: 10.1517/14656566.2015.1001737. Epub 2015 Jan 22.
Prolonged-release oxycodone/naloxone (OXN PR) showed improved gastrointestinal tolerability and equivalent analgesic efficacy compared to oxycodone alone in patients with non-cancer pain or cancer pain. This is the first dataset to demonstrate its effectiveness and safety compared to other strong opioids in opioid-naïve patients.
This is a subgroup analysis of a 4- to 6-week multicenter, observational study. A total of 162 opioid-naïve patients with moderate-to-severe pain of varying etiologies received either OXN PR or other strong opioids (control group). Documented parameters include pain relief (numeric rating scale), bowel function (Bowel Function Index [BFI]), pain-related functional impairment (Brief Pain Inventory Short Form), quality of life (QoL; EuroQol EQ-5D-3L) and a global therapy assessment.
OXN group patients experienced a substantial clinically important reduction in mean pain intensity of 51.4%, compared to a 28.6% reduction in control patients. Although the BFI remained in the reference range in both groups, there was a difference between BFI changes during treatment in favor of OXN PR. The superior effectiveness of OXN PR was paralleled by greater improvements of pain interference and QoL and fewer adverse drug reactions compared to other strong opioids.
The favorable outcomes under real-life conditions suggest that OXN PR provides a valuable option for treatment of moderate-to-severe pain without using weak opioids first.
与单独使用羟考酮相比,缓释羟考酮/纳洛酮(OXN PR)在非癌性疼痛或癌性疼痛患者中显示出更好的胃肠道耐受性和等效的镇痛效果。这是首个在未使用过阿片类药物的患者中比较其与其他强效阿片类药物有效性和安全性的数据集。
这是一项为期4至6周的多中心观察性研究的亚组分析。共有162例病因各异的中度至重度疼痛且未使用过阿片类药物的患者接受了OXN PR或其他强效阿片类药物(对照组)治疗。记录的参数包括疼痛缓解情况(数字评分量表)、肠功能(肠功能指数[BFI])、疼痛相关功能障碍(简明疼痛量表简表)、生活质量(QoL;欧洲五维度健康量表EQ-5D-3L)以及整体治疗评估。
OXN组患者的平均疼痛强度显著降低了51.4%,而对照组患者降低了28.6%。虽然两组的BFI均保持在参考范围内,但治疗期间BFI的变化存在差异,有利于OXN PR。与其他强效阿片类药物相比,OXN PR的卓越有效性伴随着疼痛干扰和QoL的更大改善以及更少的药物不良反应。
实际临床条件下的良好结果表明,OXN PR为治疗中度至重度疼痛提供了一个有价值的选择,无需先使用弱阿片类药物。