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[PMID]:28464343
[Au] Autor:Coyle C; Crawford G; Wilkinson J; Thomas SJ; Bytzer P
[Ad] Endereço:RB, Slough, Berkshire, UK.
[Ti] Título:Randomised clinical trial: addition of alginate-antacid (Gaviscon Double Action) to proton pump inhibitor therapy in patients with breakthrough symptoms.
[So] Source:Aliment Pharmacol Ther;45(12):1524-1533, 2017 06.
[Is] ISSN:1365-2036
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Symptomatic breakthrough in proton pump inhibitor (PPI)-treated gastro-oesophageal reflux disease (GERD) patients is a common problem with a range of underlying causes. The nonsystemic, raft-forming action of alginates may help resolve symptoms. AIM: To assess alginate-antacid (Gaviscon Double Action, RB, Slough, UK) as add-on therapy to once-daily PPI for suppression of breakthrough reflux symptoms. METHODS: In two randomised, double-blind studies (exploratory, n=52; confirmatory, n=262), patients taking standard-dose PPI who had breakthrough symptoms, assessed by Heartburn Reflux Dyspepsia Questionnaire (HRDQ), were randomised to add-on Gaviscon or placebo (20 mL after meals and bedtime). The exploratory study endpoint was change in HRDQ score during treatment vs run-in. The confirmatory study endpoint was "response" defined as ≥3 days reduction in the number of "bad" days (HRDQ [heartburn/regurgitation] >0.70) during treatment vs run-in. RESULTS: In the exploratory study, significantly greater reductions in HRDQ scores (heartburn/regurgitation) were observed in the Gaviscon vs placebo (least squares mean difference [95% CI] -2.10 [-3.71 to -0.48]; P=.012). Post hoc "responder" analysis of the exploratory study also revealed significantly more Gaviscon patients (75%) achieved ≥3 days reduction in "bad" days vs placebo patients (36%), P=.005. In the confirmatory study, symptomatic improvement was observed with add-on Gaviscon (51%) but there was no significant difference in response vs placebo (48%) (OR (95% CI) 1.15 (0.69-1.91), P=.5939). CONCLUSIONS: Adding Gaviscon to PPI reduced breakthrough GERD symptoms but a nearly equal response was observed for placebo. Response to intervention may vary according to whether symptoms are functional in origin.
[Mh] Termos MeSH primário: Alginatos/administração & dosagem
Hidróxido de Alumínio/administração & dosagem
Antiácidos/administração & dosagem
Dor Irruptiva/tratamento farmacológico
Refluxo Gastroesofágico/tratamento farmacológico
Inibidores da Bomba de Prótons/administração & dosagem
Ácido Silícico/administração & dosagem
Bicarbonato de Sódio/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Alginatos/efeitos adversos
Hidróxido de Alumínio/efeitos adversos
Antiácidos/efeitos adversos
Antiulcerosos/administração & dosagem
Antiulcerosos/efeitos adversos
Método Duplo-Cego
Combinação de Medicamentos
Feminino
Azia/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
Inibidores da Bomba de Prótons/efeitos adversos
Ácido Silícico/efeitos adversos
Bicarbonato de Sódio/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Alginates); 0 (Antacids); 0 (Anti-Ulcer Agents); 0 (Drug Combinations); 0 (Proton Pump Inhibitors); 1343-98-2 (Silicic Acid); 5QB0T2IUN0 (Aluminum Hydroxide); 66220-44-8 (alginate, aluminium hydroxide, magnesium trisilicate, sodium bicarbonate drug combination); 8MDF5V39QO (Sodium Bicarbonate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/apt.14064


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[PMID]:28654672
[Au] Autor:Cortesi PA; D'Angiolella LS; Vellucci R; Allegri M; Casale G; Favaretti C; Kheiraoui F; Cesana G; Mantovani LG
[Ad] Endereço:Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy.
[Ti] Título:Cost-effectiveness analysis of oral fentanyl formulations for breakthrough cancer pain treatment.
[So] Source:PLoS One;12(6):e0179523, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Breakthrough cancer Pain (BTcP) has a high prevalence in cancer population. Patients with BTcP reported relevant health care costs and poor quality of life. The study assessed the cost-effectiveness of the available Oral Fentanyl Formulations (OFFs) for BTcP in Italy. A decision-analytical model was developed to estimate costs and benefits associated with treatments, from the Italian NHS perspective. Expected reductions in pain intensity per BTcP episodes were translated into, percentage of BTcP reduction, resource use and Quality-Adjusted-Life-Years (QALYs). Relative efficacy, resources used and unit costs data were derived from the literature and validated by clinical experts. Probabilistic and deterministic sensitivity analyses were performed. At base-case analysis, Sublingual Fentanyl Citrate (FCSL) compared to other oral formulations reported a lower patient's cost (€1,960.8) and a higher efficacy (18.7% of BTcP avoided and 0.0507 QALYs gained). The sensitivity analyses confirmed the main results in all tested scenarios, with the highest impact reported by BTcP duration and health care resources consumption parameters. Between OFFs, FCSL is the cost-effective option due to faster reduction of pain intensity. However, new research is needed to better understand the economic and epidemiologic impact of BTcP, and to collect more robust data on economic and quality of life impact of the different fentanyl formulations. Different fentanyl formulations are available to manage BTcP in cancer population. The study is the first that assesses the different impact in terms of cost and effectiveness of OFFs, providing new information to better allocate the resources available to treat BTcP and highlighting the need of better data.
[Mh] Termos MeSH primário: Analgésicos Opioides/economia
Dor Irruptiva/tratamento farmacológico
Dor do Câncer/tratamento farmacológico
Fentanila/economia
Qualidade de Vida
[Mh] Termos MeSH secundário: Administração Oral
Administração Sublingual
Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/uso terapêutico
Dor Irruptiva/economia
Dor do Câncer/economia
Análise Custo-Benefício
Fentanila/administração & dosagem
Fentanila/uso terapêutico
Seres Humanos
Itália
Modelos Teóricos
Manejo da Dor
Anos de Vida Ajustados por Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0179523


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[PMID]:28549593
[Au] Autor:Tricou C; Ruer M; Ledoux M; Perceau-Chambard É; Decrept D; Chabloz C; Filbet M
[Ad] Endereço:Hospices civils de Lyon, centre hospitalier de Lyon-Sud, Department of Palliative Care, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
[Ti] Título:[Improving the quality of cancer pain management in palliative care unit: Targeted clinical audit].
[Ti] Título:Qualité de la prise en charge de la douleur du cancer en unité de soins palliatifs : audit clinique ciblé..
[So] Source:Bull Cancer;104(7-8):636-643, 2017 Jul - Aug.
[Is] ISSN:1769-6917
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Goal This study aims to assess the quality of the cancer pain management in Palliative care unit. METHOD: The method used was the targeted clinical audit. The audit grid was built according to the recommendations of the pilot Committee, and tested until the final version with 19 items was obtained. In this retrospective study, 60 consecutive patients were studied on 2 periods of time. The first one (T1) shows the gap between the patient's chart and the expected standard, and proposes corrective measures. The second one (T2) re-assesses, using the same items list, the efficacy of these measures. RESULTS: After the corrective measures, the patients' medical record documentation was significantly improved at T2 for: neuropathic pain assessment improved, from 3% (T1) to 67% (T2) (P<0.001), so did pain assessment during the titration, from 6.7% (T1) to 90% (T2) (P<0.001). The overdoses symptoms assessment improved from 17% at T1 to 93% at T2, (P=0.002) and breakthrough pain evaluation improved from 3% at T1 to 73% at T2, (P<0.001). The pain reassessment after the rescue doses improved from 10% at T1 to 73% at T2 (P<0.001). The other points improved but not significantly. CONCLUSION: The quality of the pain cancer management was improved during the audit, but some points (patient education and in patient medical record documentation) can be improved. We need to continue to implement the improvement measures in our unit.
[Mh] Termos MeSH primário: Dor Irruptiva/terapia
Dor do Câncer/terapia
Neuralgia/terapia
Manejo da Dor/normas
Cuidados Paliativos/normas
Melhoria de Qualidade
Qualidade da Assistência à Saúde
[Mh] Termos MeSH secundário: Auditoria Clínica
Feminino
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Educação de Pacientes como Assunto
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170815
[Lr] Data última revisão:
170815
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170528
[St] Status:MEDLINE


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[PMID]:28438966
[Au] Autor:Havelin J; Imbert I; Sukhtankar D; Remeniuk B; Pelletier I; Gentry J; Okun A; Tiutan T; Porreca F; King TE
[Ad] Endereço:Department of Biomedical Sciences, College of Osteopathic Medicine, Center for Excellence in the Neurosciences, University of New England, Biddeford, Maine 04005, and.
[Ti] Título:Mediation of Movement-Induced Breakthrough Cancer Pain by IB4-Binding Nociceptors in Rats.
[So] Source:J Neurosci;37(20):5111-5122, 2017 May 17.
[Is] ISSN:1529-2401
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cancer-induced bone pain is characterized by moderate to severe ongoing pain that commonly requires the use of opiates. Even when ongoing pain is well controlled, patients can suffer breakthrough pain (BTP), episodic severe pain that "breaks through" the medication. We developed a novel model of cancer-induced BTP using female rats with mammary adenocarcinoma cells sealed within the tibia. We demonstrated previously that rats with bone cancer learn to prefer a context paired with saphenous nerve block to elicit pain relief (i.e., conditioned place preference, CPP), revealing the presence of ongoing pain. Treatment with systemic morphine abolished CPP to saphenous nerve block, demonstrating control of ongoing pain. Here, we show that pairing BTP induced by experimenter-induced movement of the tumor-bearing hindlimb with a context produces conditioned place avoidance (CPA) in rats treated with morphine to control ongoing pain, consistent with clinical observation of BTP. Preventing movement-induced afferent input by saphenous nerve block before, but not after, hindlimb movement blocked movement-induced BTP. Ablation of isolectin B4 (IB4)-binding, but not TRPV1 , sensory afferents eliminated movement-induced BTP, suggesting that input from IB4-binding fibers mediates BTP. Identification of potential molecular targets specific to this population of fibers may allow for the development of peripherally restricted analgesics that control BTP and improve quality of life in patients with skeletal metastases. We present a novel preclinical measure of movement-induced breakthrough pain (BTP) that is observed in the presence of morphine controlling ongoing pain. Blockade of sensory input before movement prevented BTP, whereas nerve block after movement failed to reverse BTP. These observations indicate that blocking peripheral sensory input may prevent BTP and targeting central sites may be required for pain relief once BTP has been initiated. Preventing sensory input from TRPV1-expressing fibers failed to alter movement-induced BTP. In contrast, preventing sensory input from isolectin B4 (IB4)-binding fibers blocked movement-induced BTP. Therefore, examining molecular targets on this population of nociceptive fibers may prove useful for developing an improved strategy for preventing BTP in cancer patients with skeletal metastases.
[Mh] Termos MeSH primário: Neoplasias Ósseas/metabolismo
Dor Irruptiva/metabolismo
Dor do Câncer/metabolismo
Dor do Câncer/prevenção & controle
Glicoproteínas/metabolismo
Lectinas/metabolismo
Nociceptores/metabolismo
[Mh] Termos MeSH secundário: Animais
Neoplasias Ósseas/complicações
Dor Irruptiva/prevenção & controle
Dor do Câncer/etiologia
Feminino
Masculino
Movimento
Bloqueio Nervoso/métodos
Nociceptores/efeitos dos fármacos
Ratos
Ratos Endogâmicos F344
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glycoproteins); 0 (Lectins); 0 (isolectin B4-binding glycoprotein, rat)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171118
[Lr] Data última revisão:
171118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE
[do] DOI:10.1523/JNEUROSCI.1212-16.2017


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[PMID]:28428506
[Au] Autor:Yomiya K; Kaneshima M; Kyosaka B; Warita E; Hosonuma R; Osato S
[Ad] Endereço:Dept. of Palliative Care, Saitama Cancer Center.
[Ti] Título:[A New Therapeutic Approach for Cancer-Related Breakthrough Pain - Focused on Oral Transmucosal Fentanyl].
[So] Source:Gan To Kagaku Ryoho;44(4):289-293, 2017 Apr.
[Is] ISSN:0385-0684
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:In 2013, oral transmucosal fentanyl was first approved in Japan for reducing breakthrough pain(BTP). The development of BTP may contribute to less-effective analgesia, a reduced satisfaction with analgesia therapy, obstacles in daily life, mood disorders, and an increased use of healthcare resources. In most BTP, both the duration from BTP onset to its maximum intensity and the overall duration of BTP episodes are relatively short. The need for improved rapid pain relief for BTP in this setting has led to the development of rapid-onset opioids(ROOs), including oral transmucosal fentanyl citrate(OTFC). OTFC is characterized by a rapid onset and short duration of action. Therefore, the drug is optimally indicated for BTP in patients whose pain cannot be sufficiently controlled by the rapid-release preparation, and whose sleepiness due to the carry-over effect of analgesic action interferes with daily living. In addition, the drug can be used for patients who find it difficult to use oral preparations. Furthermore, since fentanyl is the main active ingredient, less severe side effects, such as constipation, are expected. OTFC may also be safely used for patients with renal dysfunction. Since the drug has many characteristics that differ from conventional rapid-release preparations, it is important to become familiar with the use of OTFC. In order to address improving the QOL of cancer patients, a comprehensive assessment of the patient, including the risk of BTP being inadequately controlled by conventional rescue preparations is necessary.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Dor Irruptiva/tratamento farmacológico
Dor do Câncer/tratamento farmacológico
Fentanila/uso terapêutico
Neoplasias/complicações
[Mh] Termos MeSH secundário: Administração Oral
Analgésicos Opioides/administração & dosagem
Dor do Câncer/etiologia
Fentanila/administração & dosagem
Seres Humanos
Mucosa Bucal
Manejo da Dor
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE


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[PMID]:28337672
[Au] Autor:Schug SA; Ting S
[Ad] Endereço:Chair of Anaesthesiology, Pharmacology, Pharmacy and Anaesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia. stephan.schug@uwa.edu.au.
[Ti] Título:Fentanyl Formulations in the Management of Pain: An Update.
[So] Source:Drugs;77(7):747-763, 2017 May.
[Is] ISSN:1179-1950
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Fentanyl is a synthetic, highly selective opioid with many desirable physicochemical properties, including a high lipophilicity and predictable pharmacokinetics. These properties have an established record in the management of pain in a variety of settings, particularly acute pain and breakthrough cancer pain. Fentanyl was initially developed for parenteral use; however, this is invasive and impractical in the outpatient setting. Unfortunately, the high first-pass metabolism of fentanyl makes oral formulations unfeasible. However, its high lipophilicity allows fentanyl to be absorbed via a number of other routes. Thus new formulations were designed to allow non-invasive methods of administration. Transmucosal and transdermal fentanyl formulations are well established, and have proven useful in the settings of breakthrough cancer pain, emergencies and in the paediatric population. The iontophoretic transdermal system was developed to provide a needle-free system of delivering bolus doses of fentanyl on demand, a novel way of delivering patient-controlled opioid analgesia. Transpulmonary administration of fentanyl remains experimental. The aim of this review is to provide an update on current non-parenteral fentanyl formulations, with attention to their particular pharmacokinetics and features relevant to clinical use in pain management.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Analgésicos Opioides/farmacocinética
Fentanila/administração & dosagem
Fentanila/farmacocinética
Manejo da Dor
[Mh] Termos MeSH secundário: Analgesia Controlada pelo Paciente
Analgésicos Opioides/efeitos adversos
Analgésicos Opioides/química
Dor Irruptiva/tratamento farmacológico
Vias de Administração de Medicamentos
Composição de Medicamentos
Fentanila/efeitos adversos
Fentanila/química
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1007/s40265-017-0727-z


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[PMID]:28276971
[Au] Autor:Mercadante S
[Ad] Endereço:a Anesthesia and Intensive Care, Pain relief & Supportive/Palliative Care , La Maddalena Cancer Center , Palermo , Italy.
[Ti] Título:New drugs for pain management in advanced cancer patients.
[So] Source:Expert Opin Pharmacother;18(5):497-502, 2017 Apr.
[Is] ISSN:1744-7666
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Advanced cancer patients represent a frail population, often requiring aggressive pain management, particularly in the late stage of disease, when untreated pain is one the most important causes of suffering. Areas covered: In the last decade, a series of new analgesics have been introduced in the market to offer additional options amongst existent drugs. The characteristics of these drugs, their efficacy and tolerability are examined on the basis of existent studies. Expert opinion: Although new analgesic preparations have been developed in recent years, no specific drug has provided a better analgesic performance in comparison with others. Some technologies have been developed to increase the safety or decrease the opioid-related adverse effects, with some molecules providing extra-opioid analgesia. However, existing studies did not present relevant advantages over traditional opioids. The new formulations developed to provide a rapid and non-invasive analgesia for breakthrough pain have really changed the approach to this phenomenon, characterized by a specific temporal pattern requiring a short onset, and duration of the analgesic effect. The availability of new drugs, indeed, may enlarge the possibilities of individualizing treatment, according to specific clinical needs and individual response.
[Mh] Termos MeSH primário: Analgésicos/uso terapêutico
Neoplasias/complicações
Dor/tratamento farmacológico
[Mh] Termos MeSH secundário: Analgésicos/efeitos adversos
Analgésicos Opioides/efeitos adversos
Analgésicos Opioides/uso terapêutico
Dor Irruptiva/tratamento farmacológico
Seres Humanos
Dor/etiologia
Medição da Dor
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Analgesics, Opioid)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170404
[Lr] Data última revisão:
170404
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1080/14656566.2017.1299711


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[PMID]:28213817
[Au] Autor:Olarte JM
[Ad] Endereço:Palliative Care Unit, Hospital General Universitario Gregorio Marañón, c/Dr Esquerdo 46, 28007, Madrid, Spain. jnunezo@salud.madrid.org.
[Ti] Título:Breakthrough cancer pain and rational drug use.
[So] Source:Support Care Cancer;25(Suppl 1):11-17, 2017 Apr.
[Is] ISSN:1433-7339
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Recent data indicate that there are large disparities in the use of opioid analgesics to control breakthrough cancer pain (BTcP) in Europe and worldwide. While it is clear that affordability is a key factor, it is certainly not the only one, and other factors, such as cultural differences and overall awareness, are undoubtedly responsible. More work remains to be done to overcome barriers in the use of these medications when warranted. When prescribing a medication for BTcP, it must be considered that its time profile is different from chronic persistent pain. The best control of background pain can best be achieved with a low dose of an extended opioid, and managing BTcP with a rapid-onset opioid, providing a good combination of overall pain control and lower opioid exposure. Notwithstanding their efficacy, greater attention needs to be paid to inappropriate use of opioids. It is important to evaluate patients for potential opioid misuse, including assessment of risk factors, and aberrant drug-taking behaviours must be investigated. In our institution, several measures have been adopted in this patient population in order to prevent aberrant opioid-induced behaviours. The adoption of some or all of these principles, depending on the individual patient and treatment setting, can undoubtedly help to reduce the risk of developing an aberrant behaviour related to opioid use as rescue medication for BTcP.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Dor Irruptiva/tratamento farmacológico
Neoplasias/complicações
Manejo da Dor/métodos
[Mh] Termos MeSH secundário: Dor do Câncer
Feminino
Seres Humanos
Masculino
Neoplasias/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170219
[St] Status:MEDLINE
[do] DOI:10.1007/s00520-017-3636-5


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[PMID]:27873235
[Au] Autor:Mercadante S; Marchetti P; Cuomo A; Caraceni A; Mediati RD; Mammucari M; Natoli S; Lazzari M; Dauri M; Airoldi M; Azzarello G; Bandera M; Blasi L; Cartenì G; Chiurazzi B; Costanzo BV; Degiovanni D; Fusco F; Guardamagna V; Iaffaioli V; Liguori S; Lorusso V; Mameli S; Mattioli R; Mazzei T; Melotti RM; Menardo V; Miotti D; Moroso S; De Santis S; Orsetti R; Papa A; Ricci S; Sabato AF; Scelzi E; Sofia M; Tonini G; Aielli F; Valle A; IOPS MS study group
[Ad] Endereço:Anesthesia and Intensive Care and Pain Relief and Supportive Care, La Maddalena Cancer Center, Via San Lorenzo 312, 90146, Palermo, Italy. terapiadeldolore@lamaddalenanet.it.
[Ti] Título:Breakthrough Cancer Pain: Preliminary Data of The Italian Oncologic Pain Multisetting Multicentric Survey (IOPS-MS).
[So] Source:Adv Ther;34(1):120-135, 2017 Jan.
[Is] ISSN:1865-8652
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: An ongoing national multicenter survey [Italian Oncologic Pain multiSetting Multicentric Survey (IOPS-MS)] is evaluating the characteristics of breakthrough cancer pain (BTP) in different clinical settings. Preliminary data from the first 1500 cancer patients with BTP enrolled in this study are presented here. METHODS: Thirty-two clinical centers are involved in the survey. A diagnosis of BTP was performed by a standard algorithm. Epidemiological data, Karnofsky index, stage of disease, presence and sites of metastases, ongoing oncologic treatment, and characteristics of background pain and BTP and their treatments were recorded. Background pain and BTP intensity were measured. Patients were also questioned about BTP predictability, BTP onset (≤10 or >10 min), BTP duration, background and BTP medications and their doses, time to meaningful pain relief after BTP medication, and satisfaction with BTP medication. The occurrence of adverse reactions was also assessed, as well as mucosal toxicity. RESULTS: Background pain was well controlled with opioid treatment (numerical rating scale 3.0 ± 1.1). Patients reported 2.5 ± 1.6 BTP episodes/day with a mean intensity of 7.5 ± 1.4 and duration of 43 ± 40 min; 977 patients (65.1%) reported non-predictable BTP, and 1076 patients (71.7%) reported a rapid onset of BTP (≤10 min). Higher patient satisfaction was reported by patients treated with fast onset opioids. CONCLUSIONS: These preliminary data underline that the standard algorithm used is a valid tool for a proper diagnosis of BTP in cancer patients. Moreover, rapid relief of pain is crucial for patients' satisfaction. The final IOPS-MS data are necessary to understand relationships between BTP characteristics and other clinical variables in oncologic patients. FUNDING: Molteni Farmaceutici, Italy.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Dor Irruptiva/tratamento farmacológico
Dor do Câncer/tratamento farmacológico
Manejo da Dor/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Algoritmos
Dor Irruptiva/diagnóstico
Dor Irruptiva/terapia
Dor do Câncer/diagnóstico
Dor do Câncer/epidemiologia
Dor do Câncer/terapia
Feminino
Seres Humanos
Itália/epidemiologia
Masculino
Meia-Idade
Medição da Dor
Satisfação do Paciente
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:161123
[St] Status:MEDLINE
[do] DOI:10.1007/s12325-016-0440-4


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[PMID]:27853984
[Au] Autor:Mazzola R; Ricchetti F; Fiorentino A; Giaj-Levra N; Fersino S; Tebano U; Albanese S; Gori S; Alongi F
[Ad] Endereço:Radiation Oncology Division, Sacro Cuore Don Calabria Cancer Care Center, Via Don A. Sempreboni 5, 37024, Negrar, Verona, Italy. rosariomazzola@hotmail.it.
[Ti] Título:Fentanyl pectin nasal spray for painful mucositis in head and neck cancers during intensity-modulated radiation therapy with or without chemotherapy.
[So] Source:Clin Transl Oncol;19(5):593-598, 2017 May.
[Is] ISSN:1699-3055
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of the current analysis was to evaluate the effectiveness and tolerability of rapid onset opioid in a cohort of head and neck cancer (HNC) patients affected by painful mucositis influencing swallowing function during RT ± ChT with definitive or adjuvant intent. METHODS: A retrospective analysis was conduct on HNC patients during RT ± ChT that received fentanyl pectin na sal spray (FPNS) for incidental BTP due to painful mucositis 13 min before the main meals. The period of observation has been 90 days starting from the beginning of RT ± ChT. RESULTS: Forty HNC patients with incidental BTP due to painful mucositis treated with FPNS were analyzed. The mean NRS of untreated episodes of BTP was 5.73 ± 1.54 decreasing to 2.25 ± 2.45 with FPNS (median dose 100 mcg). During the pain treatment, the number of meals increased from 2.08 ± 0.35 to 2.868 ± 0.4 (p = 0.000), and the BMI remained stable (from 25.086 ± 3.292 to 25.034 ± 3.090; p = 0.448). The 94.9% of patients was satisfied or very satisfied for the rapidity of the effect, and 97.4% for the easiness and convenience in the use. CONCLUSIONS: FPNS showed an acceptable safety activity profile in predictable BTP due to painful mucositis in HNC patients during RT ± ChT. FPNS was also effective in reducing the mucositis sequelae and allowing the completion of RT scheduled scheme. Moreover, patients declared satisfaction in terms of ease of use.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Dor Irruptiva/tratamento farmacológico
Fentanila/administração & dosagem
Neoplasias de Cabeça e Pescoço/radioterapia
Mucosite/tratamento farmacológico
Radioterapia de Intensidade Modulada/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antineoplásicos/administração & dosagem
Dor Irruptiva/etiologia
Cisplatino/administração & dosagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Mucosite/etiologia
Sprays Nasais
Manejo da Dor/métodos
Pectinas
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Antineoplastic Agents); 0 (Nasal Sprays); 0 (Pectins); 89NA02M4RX (pectin); Q20Q21Q62J (Cisplatin); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161118
[St] Status:MEDLINE
[do] DOI:10.1007/s12094-016-1570-5



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