Clinical relevance of immune checkpoint inhibitors for the analgesic effect of opioids: A retrospective propensity score analysis

IF 3.1 3区医学 Q2 PHARMACOLOGY & PHARMACY

British journal of clinical pharmacology Pub Date : 2024-12-29 DOI:10.1111/bcp.16377

Takahiro Sumimoto, Ryota Tanaka, Yuko Murakami, Ryosuke Tatsuta, Hiroki Itoh

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引用次数: 0

Abstract

Aims

This study aimed to determine the clinical relevance of the influence of coadministration of immune checkpoint inhibitors (ICIs) on the analgesic effects of opioids, focusing on the amount of change in opioid dosage.

Methods

This study used data from patients who used opioids during anticancer therapy at the Oita University Hospital between September 2014 and October 2023. The primary outcome measure was the amount of change in morphine mg equivalent opioid dose during the period of anticancer therapy. Propensity score matching was performed to reduce confounding effects.

Results

The study enrolled 235 patients; 101 received ICI and 134 received no ICI. Before propensity score matching, there were significant differences between the ICI and non-ICI groups in lines of anticancer therapy, type of primary cancer, body mass index, maximum opioid dose and the amount of change in opioid dose. Following propensity score matching, 73 patients each were included in the ICI and non-ICI groups. Analysis of the propensity score-matched cohort showed a significant increase in the median amount of change in opioid dose in ICI group vs non-ICI group (22.5 vs. 15.0 morphine mg equivalents, interquartile range; 0.0, 40.0 vs. 0.0, 30.0, P = .044). Multiple regression analysis identified ICI administration and body mass index as significant independent factors associated with the amount of change in opioid dose (P = .014 and .027, respectively).

Conclusions

ICI administration significantly increased opioid dosage regardless of patient background. Our findings would provide valuable insight into future pain management strategies.

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免疫检查点抑制剂与阿片类药物镇痛作用的临床相关性：回顾性倾向评分分析

本研究旨在确定免疫检查点抑制剂（ICIs）联合使用对阿片类药物镇痛作用影响的临床相关性，重点关注阿片类药物剂量的变化量。方法本研究使用2014年9月至2023年10月在大分大学医院接受抗癌治疗期间使用阿片类药物的患者数据。主要结局指标是在抗癌治疗期间吗啡毫克当量阿片类药物剂量的变化量。进行倾向评分匹配以减少混杂效应。结果共纳入235例患者；101例行ICI， 134例未行ICI。倾向评分匹配前，ICI组与非ICI组在抗肿瘤治疗、原发肿瘤类型、体重指数、阿片类药物最大剂量和阿片类药物剂量变化量等方面存在显著差异。根据倾向评分匹配，分别将73名患者分为ICI组和非ICI组。倾向评分匹配队列分析显示，与非ICI组相比，ICI组阿片类药物剂量变化的中位数显著增加(22.5 vs 15.0吗啡毫克当量，四分位数范围；0.0, 40.0 vs. 0.0, 30.0, P = 0.044)。多元回归分析发现，ICI给药和体重指数是影响阿片类药物剂量变化的重要独立因素(P =。分别为0.014和0.027)。结论无论患者背景如何，ICI均显著增加阿片类药物剂量。我们的发现将为未来的疼痛管理策略提供有价值的见解。

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

British journal of clinical pharmacology 医学-药学

CiteScore

6.30

自引率

8.80%

发文量

419

审稿时长

1 months

期刊介绍： Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.