Barbetta Carlo, Currow David C, Johnson Miriam J
a Respiratory Unit , AAS5 Friuli Occidentale, S. Maria degli Angeli Hospital , Pordenone , Italy.
b Centre for Cardiovascular & Chronic Care, University of Technology , Sydney , Australia.
Expert Rev Respir Med. 2017 Apr;11(4):333-341. doi: 10.1080/17476348.2017.1305896. Epub 2017 Mar 17.
To evaluate systematically randomised clinical trials investigating non-opioid medications for the management and treatment of chronic breathlessness. Areas covered: The evidence for the role of benzodiazepines, anxiolytics, selective serotonin re-uptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, cannabinoids, nebulized furosemide and herbal-based treatments were critically reviewed. Search of the Clinical Trials Registry (Clinicaltrial.gov) identified ongoing studies expected to generate new data in the near future in several classes of non-opioid medications for their net effect on chronic breathlessness. Expert commentary: Morphine still has the best level of evidence for the symptomatic treatment of chronic breathlessness. Non-opioid treatments for chronic breathlessness are less studied than morphine and morphine-related medications although evidence is emerging in relation to some options. Currently, there is insufficient evidence to recommend non-opioids in the routine treatment of chronic breathlessness. There is a need to find agents, new as well as re-purposed, that can be used as alternative therapies to opioids for chronic breathlessness for people who are unable to tolerate morphine.
为系统评估研究非阿片类药物用于慢性呼吸困难管理和治疗的随机临床试验。涵盖领域：对苯二氮䓬类药物、抗焦虑药、选择性5-羟色胺再摄取抑制剂（SSRIs）、三环类抗抑郁药、抗组胺药、大麻素、雾化速尿和草药治疗的作用证据进行了严格审查。检索临床试验注册库（Clinicaltrial.gov）发现，正在进行的研究有望在不久的将来产生关于几类非阿片类药物对慢性呼吸困难净效应的新数据。专家评论：吗啡在慢性呼吸困难的对症治疗方面仍具有最佳证据水平。尽管关于某些选择的证据正在出现，但慢性呼吸困难的非阿片类治疗研究不如吗啡和与吗啡相关的药物。目前，没有足够的证据推荐在慢性呼吸困难的常规治疗中使用非阿片类药物。有必要寻找新的以及重新利用的药物，作为无法耐受吗啡的慢性呼吸困难患者阿片类药物的替代疗法。
