Journal of Pain & Palliative Care Pharmacotherapy最新文献

A Systematic Review and Meta-Analysis of The Efficacy of Endoscopic Ultrasound Guided Celiac Plexus Blocks for Chronic Pancreatitis Pain.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-04-01 DOI: 10.1080/15360288.2025.2479481

Luke Kar Man Chan, Tanish Rao, Paolo Masangcay, Samuel Chia Lin Kuo, Tai-Tak Wan

{"title":"A Systematic Review and Meta-Analysis of The Efficacy of Endoscopic Ultrasound Guided Celiac Plexus Blocks for Chronic Pancreatitis Pain.","authors":"Luke Kar Man Chan, Tanish Rao, Paolo Masangcay, Samuel Chia Lin Kuo, Tai-Tak Wan","doi":"10.1080/15360288.2025.2479481","DOIUrl":"https://doi.org/10.1080/15360288.2025.2479481","url":null,"abstract":"Chronic pancreatitis is a globally prevalent progressive disease, with pain affecting up to 90% of patients, significantly impairing quality of life and leading to high rates of disability, hospitalizations, and opioid dependence. Pain management is crucial in treating chronic pancreatitis, with endoscopic ultrasound-guided celiac plexus block (EUS-CPB) recognized as an interventional option. This systematic review and meta-analysis, following PRISMA guidelines, synthesized data from 12 studies (5 randomized control trials and 7 observational) on the efficacy of EUS-CPB in managing chronic pancreatitis pain. The overall analysis revealed a significant pain relief proportion of 0.64 (n=612) with moderate heterogeneity. Subgroup analyses revealed a proportion of 0.72 in RCTs and 0.59 in observational studies. Common complications included diarrhea and exacerbation of abdominal pain, with no reported mortality. Despite variations in efficacy due to study heterogeneity and patient differences, the findings suggest EUS-CPB as a safe and effective option, with effects lasting weeks to months. Recent studies have demonstrated the applicability of EUS-CPB across ethnically diverse and pediatric populations. However, limitations including small sample sizes and study variability highlight the need for personalized treatment approaches. Future larger randomized sham-controlled trials are recommended to better assess the duration of pain relief and impact on opioid use.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-12"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Prophylactic Dual Histamine Blockade on Filgrastim-Induced Bone Pain in Female Cancer Patients: Single Institutional Analysis.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-03-27 DOI: 10.1080/15360288.2025.2482884

Noor Ul Ain Azam, Fauzia Abdus Samad, Abdus Samad Syed, Asif Riaz Khan, Aalia Mushtaq, Faraz Saif

{"title":"Effect of Prophylactic Dual Histamine Blockade on Filgrastim-Induced Bone Pain in Female Cancer Patients: Single Institutional Analysis.","authors":"Noor Ul Ain Azam, Fauzia Abdus Samad, Abdus Samad Syed, Asif Riaz Khan, Aalia Mushtaq, Faraz Saif","doi":"10.1080/15360288.2025.2482884","DOIUrl":"https://doi.org/10.1080/15360288.2025.2482884","url":null,"abstract":"Bone pain is the commonest side-effect faced by cancer patients receiving granulocyte colony stimulating factor (G-CSF) therapy for the primary or secondary prevention of febrile neutropenia. We conducted a prospective quasi-experimental study at our setup to see the efficacy of dual histamine blockade (combined H1 and H2 receptor blockers) for preventing G-CSF-induced bone pain. Adult female patients with solid tumors who had received filgrastim for the primary prophylaxis of febrile neutropenia and met our inclusion criteria, were enrolled (n = 119). This population was analyzed for the development of significant bone pain 24 h after the administration of Filgrastim. Significant bone pain in our study was defined as emergence of new onset pain measuring ≥4 on 11-point Numerical rating scale (NRS) or at least ≥ 2-point increase in score when compared to the baseline pain (if any). Those patients who experienced significant bone pain (n = 47) were given Loratadine 10 mg and Famotidine 20 mg orally half an hour before the next filgrastim administration. Pain assessment was done 24 h after Filgrastim administration, using NRS and data was analyzed. The mean NRS score in our patients after administration of filgrastim was 6.87 ± 1.055. Most of these patients (n = 34 i.e 72%) experienced relief in bone pain after dual histamine blockade use. The mean NRS score following the use of dual antihistamines was 4.36 ± 1.870. The NRS score improved by a mean of 2.51 after using dual histamine blockade, which was statistically significant (p-value= 0.0005). We propose that dualhistamine blockade may prove to be an effective option for prophylaxis of G-CSF-induced-bone-pain. Randomized control trials on larger and more diverse patient populations are required to reinforce the findings.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-10"},"PeriodicalIF":0.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving Support for Family Caregivers in Palliative Care: Insights and Policy Implications.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-03-21 DOI: 10.1080/15360288.2025.2480226

John Patrick C Toledo

引用次数: 0

Comparison of Risk Prediction Models to Estimate Opioid-Induced Respiratory Depression, Oversedation, and Overdose in Patients with Cancer.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-03-20 DOI: 10.1080/15360288.2025.2481186

Norint P Tung, Parker K Kaleo, Eric J Roeland, Joseph D Ma

{"title":"Comparison of Risk Prediction Models to Estimate Opioid-Induced Respiratory Depression, Oversedation, and Overdose in Patients with Cancer.","authors":"Norint P Tung, Parker K Kaleo, Eric J Roeland, Joseph D Ma","doi":"10.1080/15360288.2025.2481186","DOIUrl":"https://doi.org/10.1080/15360288.2025.2481186","url":null,"abstract":"Numerous opioid-induced respiratory depression (OIRD), oversedation, and overdose prediction models exist to quantify a probability or estimate risk severity for a future event. The primary aim was to determine OIRD, oversedation, and overdose risk severity (i.e., low, moderate, and high) and agreement of risk severity between three previously published prediction models. This single-center, retrospective analysis evaluated 134 patients with cancer. Sixty-five (49%) patients were Caucasian. Forty-three (32%) patients were diagnosed with gastrointestinal cancer. Predictive factors from prediction models were concurrent sedating medication (n = 119, 89%), female sex (n = 85, 63%), a mental health diagnosis (n = 68, 51%), and antidepressant use (n = 55, 41%). For most patients, risk severity varied between moderate to high risk. Risk class severity was significantly different between prediction models (p ≤ 0.05). Frequencies of risk severity agreement between all three prediction models, between two prediction models, and no agreement was 16% (n = 22), 69% (n = 93), and 14% (n = 19), respectively. Additional research is needed to evaluate model calibration to increase OIRD, oversedation, and overdose prediction model validity and generalizability for future clinical implementation.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-9"},"PeriodicalIF":0.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Gravedigger.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-02-24 DOI: 10.1080/15360288.2025.2470436

João Guilherme Bochnia Küster

引用次数: 0

Comparing Maintenance Therapy Achievement for Opioid-Experienced Patients Converted to Buprenorphine for Chronic Pain Management.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-02-20 DOI: 10.1080/15360288.2025.2464686

Caylee Sams, Serena Cheng

{"title":"Comparing Maintenance Therapy Achievement for Opioid-Experienced Patients Converted to Buprenorphine for Chronic Pain Management.","authors":"Caylee Sams, Serena Cheng","doi":"10.1080/15360288.2025.2464686","DOIUrl":"https://doi.org/10.1080/15360288.2025.2464686","url":null,"abstract":"Treatment of chronic, non-cancer pain can be challenging in the presence of long-term opioid therapy (LTOT). Buprenorphine products can provide a unique option for chronic pain treatment due to the improved safety profile with a ceiling effect on respiratory depression. Drug manufacturers provide recommendations for conversion from full mu agonist to buprenorphine which typically includes tapering to lower morphine equivalent doses (MEDD). This study will attempt to compare if there is a difference in the ability of achieving buprenorphine maintenance therapy for chronic pain based on the starting opioid MEDD. This study's primary endpoint is the difference in ability to achieve buprenorphine maintenance therapy for chronic, non-cancer pain based on baseline MEDD (i.e., ≤30 MEDD vs >30 MEDD). Secondary endpoints will describe method of conversion to buprenorphine, difference in frequency of follow up and average time to achieve maintenance doses. There was no difference in ability to achieve buprenorphine maintenance doses between either group. Approximately 40% of patients in each group achieved maintenance doses regardless of baseline MEDD. Patients on higher MEDDs had the same likelihood of achieving buprenorphine maintenance therapy for chronic pain as those were at 30 MEDD and can be considered for buprenorphine therapy without tapering first.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-7"},"PeriodicalIF":0.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful Initiation of Buprenorphine for Chronic Non-Cancer Pain in an Opioid-Experienced Patient: A Case Report.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-02-12 DOI: 10.1080/15360288.2025.2459169

Milagros D Silva, Kyaw Zaw Linn

引用次数: 0

Retrospective Observational Descriptive Study on Use and Rotations to Belbuca^®.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-02-12 DOI: 10.1080/15360288.2025.2462602

Mia Barbieri, Neil K Shah, Julia Iskra, Nicholas Field, Stephen Gruver

{"title":"Retrospective Observational Descriptive Study on Use and Rotations to Belbuca®.","authors":"Mia Barbieri, Neil K Shah, Julia Iskra, Nicholas Field, Stephen Gruver","doi":"10.1080/15360288.2025.2462602","DOIUrl":"https://doi.org/10.1080/15360288.2025.2462602","url":null,"abstract":"The purpose of this study was to better characterize morphine equivalent daily dose (MEDD) equivalencies with buccal buprenorphine, and identify real-world efficacy and safety outcomes associated with the use of buccal buprenorphine for chronic pain at a local VA Medical Center. This study was a retrospective chart review of Computerized Patient Record System (CPRS) patient records with outpatient prescriptions for buccal buprenorphine (Belbuca®). Overall, there was a high discontinuation rate of Belbuca®: being 60% or greater across all different patient groups. These high attrition rates may potentially be result of failure to titrate to an optimal dose of Belbuca® needed for adequate analgesia. Those fully rotated fared marginally better than those partially rotated in that those fully rotated discontinued at a lesser rate and less quickly than those who were partially rotated. From the results of this study, a local dosing scheme for Belbuca® based on baseline MEDD was created for facility level guidance. The exact MEDD conversion ratio, however, for individual buprenorphine products as well as MEDD contributed by these products on a patient's overall opioid related risk compared to other full agonist opioids still remains unclear and further studies are warranted.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-15"},"PeriodicalIF":0.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

UK Medical Cannabis Registry: An Analysis of Clinical Outcomes of Medicinal Cannabis Therapy for Cancer Pain.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-02-08 DOI: 10.1080/15360288.2025.2457101

Madhur Varadpande, Simon Erridge, Arushika Aggarwal, Isaac Cowley, Lilia Evans, Evonne Clarke, Katy McLachlan, Ross Coomber, James J Rucker, Michael W Platt, Shaheen Khan, Mikael Sodergren

{"title":"UK Medical Cannabis Registry: An Analysis of Clinical Outcomes of Medicinal Cannabis Therapy for Cancer Pain.","authors":"Madhur Varadpande, Simon Erridge, Arushika Aggarwal, Isaac Cowley, Lilia Evans, Evonne Clarke, Katy McLachlan, Ross Coomber, James J Rucker, Michael W Platt, Shaheen Khan, Mikael Sodergren","doi":"10.1080/15360288.2025.2457101","DOIUrl":"https://doi.org/10.1080/15360288.2025.2457101","url":null,"abstract":"Cancer pain (CP) is a prevalent condition with limited pharmacotherapeutic options. Cannabis-based medicinal products (CBMPs) have shown analgesic effects, but their efficacy in CP remains contentious. This study aims to evaluate the change in patient-reported outcome measures (PROMs) and adverse events (AEs) in CP patients treated with CBMPs. A case series was conducted using prospectively collected clinical data from the UK Medical Cannabis Registry. Primary outcomes were the changes in the Brief Pain Inventory (BPI), pain visual analogue scale (Pain-VAS), EQ-5D-5L, Generalized Anxiety Disorder-7 (GAD-7), Patient Global Impression of Change (PGIC) and Single-Item Sleep Quality Scale (SQS) questionnaires from baseline to 1, 3, and 6 months. AEs were recorded and graded. p < 0.050 was considered statistically significant. One hundred and sixty-eight participants were included. CBMPs were associated with improvements in all pain-specific PROMs at all follow-up periods (p < 0.050). Improvements in GAD-7, SQS, and EQ-5D-5L index scores were also observed (p < 0.050). Twenty-nine AEs (17.26%) were reported by five patients (2.98%), mostly mild-to-moderate (72.41%). Although the observational design means causality cannot be established, the findings support the development of future randomized controlled trials into CP management with CBMPs.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-21"},"PeriodicalIF":0.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of Low-Dose Naltrexone for Chronic Pain Management.

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-02-03 DOI: 10.1080/15360288.2025.2456279

Alexa Spargo, Lauren Gonser, Brittany Faley

{"title":"Evaluation of Low-Dose Naltrexone for Chronic Pain Management.","authors":"Alexa Spargo, Lauren Gonser, Brittany Faley","doi":"10.1080/15360288.2025.2456279","DOIUrl":"https://doi.org/10.1080/15360288.2025.2456279","url":null,"abstract":"Naltrexone is an opioid antagonist approved by the Food and Drug Administration (FDA) for alcohol use disorder and opioid use disorder. More recently, naltrexone has been used off-label at low doses of 4.5 mg daily for chronic pain due to fibromyalgia, neuropathy, complex regional pain syndrome, and multiple sclerosis. While several studies show the promise of low-dose naltrexone in treating chronic pain, most had small sample sizes and short-term follow up, which warrants additional investigation into the effectiveness of low-dose naltrexone. This medication use evaluation aimed to evaluate the effectiveness of low-dose naltrexone for chronic pain in Veterans through retrospective chart review. The average duration of low-dose naltrexone therapy was 123 days with approximately half of Veterans still taking it at the time of chart review. The average change in pain score from initiation to most recent visit was -0.83. Low-dose naltrexone was generally well-tolerated with 32% (13 of 41) of Veterans reporting adverse effects including vivid dreams, drowsiness, dizziness, and nausea. Low-dose naltrexone resulted in a small decrease in pain, although may be considered after a patient has failed multiple lines of therapy for additional pain control after a risk versus benefits discussion.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-4"},"PeriodicalIF":0.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0