Tanaka Rei, Hashizume Takahiro, Hisanaga Tadashi, Masuda Shinya, Sato Junya, Ishikawa Hiroshi, Tanaka Hironori, Saitoh Akiyoshi, Sato Tetsumi, Kamoshida Takeshi, Sato Tetsu, Shino Michihiro
Department of Pharmacy, Shizuoka Cancer Center, Shizuoka, Japan.
Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, Kanagawa, Japan.
J Pharm Health Care Sci. 2024 Dec 19;10(1):82. doi: 10.1186/s40780-024-00401-6.
Continuous subcutaneous administration of injectable opioids is simple and effective; however, skin disorders may occur when high opioid dosages are used. Therefore, we investigated opioid injection drugs with a low risk of skin disorders.
A retrospective study was conducted using the electronic medical records of patients prescribed 1% hydromorphone hydrochloride or 4% morphine hydrochloride with instructions for continuous subcutaneous administration at Shizuoka Cancer Center from January 2017 to December 2021. The primary endpoint was skin disorders incidence, and the two groups were compared using Cox proportional hazards model analyses and Fisher's exact test at 5% significance level. Patient background factors expected to influence skin disorders were also investigated, and multivariate logistic analysis of skin disorders incidence was performed.
The incidence of skin disorders in the hydromorphone hydrochloride and morphine hydrochloride groups were 3.7% (1/27 patients) and 28.1% (9/32 patients), respectively, showing a significant difference in two statistical analyses between the two groups (Cox proportional hazards model analyses HR: 0.09, 95% CI: 0.01-0.70, P = 0.022. Fisher's exact test OR: 0.10, 95% CI: 0.01-0.84, P = 0.016). In the multivariate analysis, the administration of hydromorphone hydrochloride (OR: 0.04, 95% CI: 0.003-0.48, P = 0.012) was also found to have a significant negative correlation with the occurrence of skin disorders. On the contrary, administration period ≥ 28 days (OR: 18.16, 95% CI: 2.22-148.60, P = 0.007) was a factor with a significant positive correlation.
Subcutaneous 1% hydromorphone hydrochloride administration had a lower risk of skin disorders than 4% morphine hydrochloride injection. Moreover, prolonging the administration period increased the risk of developing skin disorders. This suggests that a 1% hydromorphone hydrochloride Injection is a good clinical decision for patients who are likely to have a longer administration period and require a higher dosage of injectable opioids.
Retrospectively registered.
连续皮下注射阿片类药物简单有效；然而，使用高剂量阿片类药物时可能会出现皮肤疾病。因此，我们研究了皮肤疾病风险较低的阿片类注射药物。
采用回顾性研究，使用静冈癌症中心2017年1月至2021年12月期间开具1%盐酸氢吗啡酮或4%盐酸吗啡并指示连续皮下给药的患者的电子病历。主要终点是皮肤疾病发生率，两组采用Cox比例风险模型分析和Fisher精确检验进行比较，显著性水平为5%。还调查了预期会影响皮肤疾病的患者背景因素，并对皮肤疾病发生率进行了多因素逻辑分析。
盐酸氢吗啡酮组和盐酸吗啡组的皮肤疾病发生率分别为3.7%（27例患者中的1例）和28.1%（32例患者中的9例），两组在两项统计分析中显示出显著差异（Cox比例风险模型分析HR：0.09，95%CI：0.01-0.70，P = 0.022。Fisher精确检验OR：0.10，95%CI：0.01-0.84，P = 0.016）。在多因素分析中，还发现使用盐酸氢吗啡酮（OR：0.04，95%CI：0.003-0.48，P = 0.012）与皮肤疾病的发生呈显著负相关。相反，给药期≥28天（OR：18.16，95%CI：2.22-148.60，P = 0.007）是一个具有显著正相关的因素。
皮下注射1%盐酸氢吗啡酮的皮肤疾病风险低于4%盐酸吗啡注射。此外，延长给药期会增加发生皮肤疾病的风险。这表明，对于给药期可能较长且需要较高剂量阿片类注射药物的患者，1%盐酸氢吗啡酮注射是一个良好的临床选择。
回顾性注册。
