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长期、缓释口服酒石酸布托啡诺治疗难治性慢性腰痛:一项单中心、观察性研究。

Long-term, prolonged-release oral tapentadol for the treatment of refractory chronic low back pain: a single-center, observational study.

机构信息

Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.

Department of Anesthesia, Resuscitation and Pain Therapy, Catholic University of Rome, Rome, Italy.

出版信息

Minerva Med. 2018 Aug;109(4):259-265. doi: 10.23736/S0026-4806.18.05641-0.

DOI:10.23736/S0026-4806.18.05641-0
PMID:29947490
Abstract

BACKGROUND

Chronic back pain is a leading cause of disability worldwide and it is still inadequately treated. Tapentadol is a dual-acting analgesic drug μ-opioid receptor (MOR) agonist/norepinephrine reuptake inhibitor, carrying a lower risk for opioid withdrawal symptoms and opioid-related adverse effects in comparison to potent opioid drugs. This study investigates the effectiveness, safety and tolerability of the prolonged release oral formulation of tapentadol (tapentadol PR) in 27 patients affected by refractory chronic low back pain during a long-term follow-up (up to 51 months).

METHODS

This is an observational study conducted at the Pain Therapy and Palliative Care Unit of University Hospital of Cagliari, Italy. We enrolled 27 patients affected by chronic low back pain refractory to other pharmacological treatments according to the inclusion criteria. We prospectively evaluated oral tapentadol PR therapy during a long-term follow-up (up to 51 months) according to the following outcomes: pain intensity during the previous 72 hours (Numeric Rating Scale 3), quality of life (Short Form-12 Health Survey), self-reported treatment effectiveness (Patient Global Impression of Change scale), physician evaluation of treatment effectiveness (Clinician Global Impression of Change scale), treatment-related adverse effects, reason for tapentadol therapy interruption and tapentadol dosage.

RESULTS

All the patients reported a significant improvement of pain intensity and quality of life at the last follow-up.

CONCLUSIONS

These results show the long-term effectiveness, safety and tolerability of oral tapentadol PR for the treatment of refractory chronic low back pain in a real-life clinical setting.

摘要

背景

慢性背痛是全球导致残疾的主要原因,但其治疗仍不充分。曲马多是一种双重作用的镇痛药物,μ 阿片受体(MOR)激动剂/去甲肾上腺素再摄取抑制剂,与强效阿片类药物相比,曲马多具有较低的阿片类戒断症状和阿片类相关不良反应风险。本研究调查了在长期随访(长达 51 个月)期间,27 例难治性慢性腰痛患者使用曲马多缓释口服制剂(曲马多 PR)的疗效、安全性和耐受性。

方法

这是一项在意大利卡利亚里大学医院疼痛治疗和姑息治疗科进行的观察性研究。我们根据纳入标准纳入了 27 例符合慢性腰痛难治性标准的患者。我们前瞻性地评估了长期随访(长达 51 个月)期间口服曲马多 PR 治疗的情况,根据以下结果进行评估:过去 72 小时的疼痛强度(数字评分量表 3)、生活质量(SF-12 健康调查)、自我报告的治疗效果(患者总体印象变化量表)、医生对治疗效果的评估(临床医生总体印象变化量表)、治疗相关不良反应、停止曲马多治疗的原因和曲马多剂量。

结果

所有患者在最后一次随访时均报告疼痛强度和生活质量有显著改善。

结论

这些结果表明,在真实临床环境中,口服曲马多 PR 治疗难治性慢性腰痛具有长期疗效、安全性和耐受性。

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