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[紫杉醇相关急性疼痛综合征在紫杉醇给药前使用或未使用过非甾体抗炎药的患者中均有发生]

[Paclitaxel-associated Acute Pain Syndrome Similarly Occurs in the Patients with or without Previously Administered Non-steroidal Anti-inflammatory Drugs Prior to Paclitaxel Administration].

作者信息

Saito Yoshitaka, Yamada Takehiro, Kobayashi Masaki, Sakakibara-Konishi Jun, Shinagawa Naofumi, Kinoshita Ichiro, Dosaka-Akita Hirotoshi, Iseki Ken

机构信息

Department of Pharmacy, Hokkaido University Hospital.

First Department of Medicine, Hokkaido University Hospital.

出版信息

Yakugaku Zasshi. 2019;139(12):1601-1608. doi: 10.1248/yakushi.19-00148.

Abstract

Paclitaxel (PTX)-associated acute pain syndrome (P-APS) is characterized by disabling but transient arthralgia and myalgia in up to 80% of patients administered with PTX. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely administered to patients with cancer who have pain or fever, and are mainly used to manage P-APS. In this study, we investigated how P-APS appear in the patients who were administered NSAIDs prior to PTX injection. The incidence or severity and duration of P-APS in patients previously administered NSAIDs were compared to those of patients who were not administered NSAIDs. The relationship between previously administered NSAIDs and rescue administration for the relief of P-APS was also evaluated. It was revealed that the incidence and duration of P-APS were 72% and 4.67±2.30 d, respectively, in the control group and 84% and 6.19±3.30 d, respectively, in the NSAIDs group. There was no significant difference in the incidence and duration and the severity of P-APS between the two groups. Patients who were previously administered NSAIDs tended to obtain less pain relief from NSAIDs administered as rescue medications, and needed other medication. Univariate and multivariate analysis revealed no correlation between previously administered NSAIDs or patient characteristics and the incidence of P-APS. In this study, it was found that clinical condition that needs NSAIDs and previously administered NSAIDs prior to PTX injection do not affect the incidence, severity, and duration of P-APS. These results will help in educating patients about their medications and will contribute to the management of P-APS.

摘要

紫杉醇(PTX)相关急性疼痛综合征(P-APS)的特征是,在接受PTX治疗的患者中,高达80%会出现导致功能障碍但为短暂性的关节痛和肌痛。非甾体抗炎药(NSAIDs)被广泛用于患有疼痛或发热的癌症患者,主要用于处理P-APS。在本研究中,我们调查了在注射PTX前服用NSAIDs的患者中P-APS是如何出现的。将先前服用NSAIDs的患者中P-APS的发生率、严重程度和持续时间与未服用NSAIDs的患者进行比较。还评估了先前服用的NSAIDs与用于缓解P-APS的补救用药之间的关系。结果显示,对照组中P-APS的发生率和持续时间分别为72%和4.67±2.30天,NSAIDs组分别为84%和6.19±3.30天。两组之间P-APS的发生率、持续时间和严重程度没有显著差异。先前服用NSAIDs的患者从作为补救药物服用的NSAIDs中获得的疼痛缓解往往较少,需要其他药物。单因素和多因素分析显示,先前服用的NSAIDs或患者特征与P-APS的发生率之间没有相关性。在本研究中,发现需要NSAIDs的临床状况以及PTX注射前先前服用的NSAIDs不会影响P-APS的发生率、严重程度和持续时间。这些结果将有助于对患者进行用药教育,并有助于P-APS的管理。

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