Oxycodone/naloxone versus tapentadol in real-world chronic non-cancer pain management: an observational and pharmacogenetic study.
Por:
Barrachina J, Margarit C, Muriel J, López-Gil S, López-Gil V, Vara-González A, Planelles B, Inda MD, Morales D and Peiró AM
Publicada:
16 jun 2022
Ahead of Print:
16 jun 2022
Resumen:
Tapentadol (TAP) and oxycodone/naloxone (OXN) potentially offer an improved opioid tolerability. However, real-world studies in chronic non-cancer pain (CNCP) remain scarce. Our aim was to compare effectiveness and security in daily pain practice, together with the influence of pharmacogenetic markers. An observational study was developed with ambulatory test cases under TAP (n = 194) or OXN (n = 175) prescription with controls (prescribed with other opioids (control), n = 216) CNCP patients. Pain intensity and relief, quality of life, morphine equivalent daily doses (MEDD), concomitant analgesic drugs, adverse events (AEs), hospital frequentation and genetic variants of OPRM1 (rs1799971, A118G) and COMT (rs4680, G472A) genes, were analysed. Test CNCP cases evidenced a significantly higher pain relief predictable due to pain intensity and quality of life (R(2) = 0.3), in front of controls. Here, OXN achieved the greatest pain relief under a 28% higher MEDD, 8-13% higher use of pregabalin and duloxetine, and 23% more prescription change due to pain, compared to TAP. Whilst, TAP yielded a better tolerability due the lower number of 4 [0-6] AEs/patient, in front of OXN. Furthermore, OXN COMT-AA homozygotes evidenced higher rates of erythema and vomiting, especially in females. CNCP real-world patients achieved higher pain relief than other traditional opioids with a better tolerability for TAP. Further research is necessary to clarify the potential influence of COMT and sex on OXN side-effects.
Filiaciones:
:
Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
:
Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
Pain Unit, Department of Health of Alicante - General Hospital, Alicante, Spain
:
Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
Pain Unit, Department of Health of Alicante - General Hospital, Alicante, Spain
:
Occupational Observatory, Miguel Hernández University of Elche, Alicante, Spain
:
Occupational Observatory, Miguel Hernández University of Elche, Alicante, Spain
Vara-González A:
Occupational Observatory, Miguel Hernández University of Elche, Alicante, Spain
:
Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernandez University of Elche, Elche, Spain
:
Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
Morales D:
Operations Research Centre, Miguel Hernández University of Elche, Elche, Spain
:
Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernández University of Elche, Elche, Spain.
Clinical Pharmacology Unit, Department of Health of Alicante - General Hospital, Alicante, Spain.
Neuropharmacology on Pain (NED) Research Group, Hospital General Universitario de Alicante, C/Pintor Baeza, 12, 03010, Alicante, Spain.
gold, Green Accepted
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