Buprenorphine for the Treatment of Pain in Cancer Patients.

Q3 Medicine

Journal of opioid management Pub Date : 2024-07-01 DOI:10.5055/bupe.24.rpj.1015

Marcin Chwistek, Dylan Sherry, Leigh Kinczewski

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引用次数: 0

Abstract

Background: Opioids remain the cornerstone for the treatment of moderate to severe cancer pain. Due to benefits over full agonist opioids (FAO), buprenorphine has emerged as an alternative treatment.

Purpose/hypothesis: Buprenorphine is only approved for the treatment of pain that is chronic non-cancer. Cancer-related pain is often progressive with breakthrough pain. There is limited evidence for using short-acting FAO in combination with buprenorphine. There are concerns about withdrawal and the efficacy of pain control using buprenorphine. We hypothesize buprenorphine, in combination with short-acting FAOs, can adequately control cancer- related pain without causing withdrawal symptoms. Procedures/data/observations: Our prospective, single-arm, open-label study enrolls patients with cancer-related pain who are on buprenorphine in combination with an FAO at > 30 mg OME/day, either requiring long-acting pain relief or their pain is not controlled with an FAO alone. Our study is ongoing, with 15 patients enrolled and a target of 50. The patient's pain is self-assessed daily using a mobile application. Withdrawal is assessed regularly using a modified Clinical Opioid Withdrawal Scale (COWS) score.

Conclusions/applications: Buprenorphine appears to be effective for the treatment of cancer pain without causing withdrawal in combination with short-acting FAO >30 mg/day.

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治疗癌症患者疼痛的丁丙诺啡。

背景：阿片类药物仍然是治疗中度至重度癌痛的基石。与全激动阿片类药物（FAO）相比，丁丙诺啡具有更多优势，因此已成为一种替代疗法：丁丙诺啡仅被批准用于治疗慢性非癌症疼痛。与癌症相关的疼痛通常是渐进性的，并伴有突破性疼痛。将短效 FAO 与丁丙诺啡联合使用的证据有限。人们对丁丙诺啡的戒断和疼痛控制效果表示担忧。我们推测，丁丙诺啡与短效FAO联用可充分控制与癌症相关的疼痛，且不会引起戒断症状。程序/数据/观察结果：我们的前瞻性、单臂、开放标签研究招募了正在服用丁丙诺啡和呋喃唑酮的癌症相关疼痛患者，剂量大于 30 毫克 OME/天，这些患者需要长效止痛药，或者单用呋喃唑酮无法控制疼痛。我们的研究正在进行中，目前已有 15 名患者加入，目标人数为 50 人。患者每天使用手机应用程序对疼痛进行自我评估。戒断情况定期使用改良的临床阿片类药物戒断量表（COWS）评分进行评估：丁丙诺啡与大于 30 毫克/天的短效阿片类药物联用似乎可有效治疗癌痛，且不会导致戒断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of opioid management Medicine-Anesthesiology and Pain Medicine

CiteScore

1.00

自引率

0.00%

发文量

期刊介绍： The Journal of Opioid Management deals with all aspects of opioids. From basic science, pre-clinical, clinical, abuse, compliance and addiction medicine, the journal provides and unbiased forum for researchers and clinicians to explore and manage the complexities of opioid prescription.