High BMI predicts poor cancer pain relief when rotating from oral opioids to transdermal Fentanyl: a two-center retrospective study.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pharmacological Reports Pub Date : 2025-06-01 Epub Date: 2025-04-11 DOI:10.1007/s43440-025-00723-8

Ya Chen, Songling Han, Xiaogang Hu, Xue Ma, Yue Qiu, Yuelu Tang, Xiaoxiao Wang, Lixian Li, Chao Li, Wanyi Chen

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引用次数: 0

Abstract

Background: The analgesic effect of transdermal fentanyl (TDF) differs among cancer pain patients. This study aims to investigate the relationship between clinical factors and pain relief when using TDF in cancer pain patients who rotate from oral opioids to TDF.

Methods: A two-center retrospective study was conducted in Chongqing University Cancer Hospital and Sichuan Cancer Hospital, including adult cancer pain patients who rotated from oral opioids to TDF between 2018 and 2022. Based on the clinical characteristics, logistic regressions and directed acyclic graphs (DAG) were employed to identify significant factors influencing the efficacy of TDF. The study adhered to STROBE guidelines.

Results: This survey included 359 patients, among them, 254 patients (70.8%) attained good pain relief after rotating to TDF. 59.3% of patients utilized TDF at standard dosage, while 24.8% used underdose TDF, with only 52.8% achieving adequate pain relief, significantly lower than other groups (p < 0.001). Initial univariable analysis of 22 clinical factors among the standard dose group showed that a higher body mass index (BMI, median 23.2 kg/m² vs. 21.0 kg/m², OR = 0.83 [0.75-0.91], p < 0.001) and the presence of lung cancer (OR = 0.31 [0.11-0.89], p = 0.030) predicted potentially unsatisfactory pain control after TDF treatment. Subsequently, a multivariable regression analysis based on DAG-directed factor selection identified BMI (OR = 0.82 [0.74-0.92], adjusted p < 0.01) as the only independent factor influencing TDF effectiveness.

Conclusions: Our study suggested that high BMI was a significant predictor of poor cancer pain relief when rotating from oral opioids to TDF, and provides a useful measurement of managing adult cancer pain when using TDF.

Trial registration: ClinicalTrials.gov, NCT06369961, registered on April 11, 2024; https://clinicaltrials.gov/study/NCT06369961 .

查看原文本刊更多论文

当从口服阿片类药物转向透皮芬太尼时，高BMI预示着癌症疼痛缓解不良：一项双中心回顾性研究。

背景：经皮芬太尼（TDF）在癌症疼痛患者中的镇痛效果不同。本研究旨在探讨从口服阿片类药物转向TDF的癌症疼痛患者使用TDF时，临床因素与疼痛缓解的关系。方法：在重庆大学肿瘤医院和四川肿瘤医院开展双中心回顾性研究，纳入2018 - 2022年间从口服阿片类药物轮转至TDF的成年癌性疼痛患者。根据临床特点，采用logistic回归和有向无环图（DAG）分析影响TDF疗效的显著因素。该研究遵循STROBE指南。结果：本组共纳入359例患者，其中254例（70.8%）患者旋转至TDF后疼痛得到良好缓解。59.3%的患者使用标准剂量的TDF，而24.8%的患者使用不足剂量的TDF，只有52.8%的患者达到充分的疼痛缓解，显著低于其他组(p)结论：我们的研究表明，当从口服阿片类药物转向TDF时，高BMI是癌症疼痛缓解不良的重要预测因子，并提供了使用TDF时管理成人癌症疼痛的有用测量。试验注册：ClinicalTrials.gov, NCT06369961，注册日期为2024年4月11日；https://clinicaltrials.gov/study/NCT06369961。

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

Pharmacological Reports 医学-药学

CiteScore

8.40

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： Pharmacological Reports publishes articles concerning all aspects of pharmacology, dealing with the action of drugs at a cellular and molecular level, and papers on the relationship between molecular structure and biological activity as well as reports on compounds with well-defined chemical structures. Pharmacological Reports is an open forum to disseminate recent developments in: pharmacology, behavioural brain research, evidence-based complementary biochemical pharmacology, medicinal chemistry and biochemistry, drug discovery, neuro-psychopharmacology and biological psychiatry, neuroscience and neuropharmacology, cellular and molecular neuroscience, molecular biology, cell biology, toxicology. Studies of plant extracts are not suitable for Pharmacological Reports.