c i a l D i s t r i b u t i o n U n a u t h o r i z e d u s e p r o h i b i t e d . A u t h o r i s e d u s e r s c a n d o w n l o a d , d i s p l a y , v i e w a n d p r i n t a s i n g l e c o p y f o r p e r s o n a l u s eCurrent Medical Research & Opinion Vol. 30, No. 4, 2014, 555-564 0300-7995 Article RT-0359. R1/866545 doi:10.1185/03007995.2013.866545 All rights reserved: reproduction in whole or part not permitted
Results:Of 200 patients (mean age 65.9 years; 54% female) with NP included in the analysis; 97% completed 8 weeks' treatment. At the observation start, all patients were taking anticonvulsants and complained of constipation, and 60% were receiving opioids. Pain intensity and DN4 score decreased significantly by endpoint (NRS p50.0001; DN4 p50.0001) and need for rescue analgesics abated. Reduction in pain intensity throughout the observation was similar regardless of NP aetiology. According to PGIC, 87.8% of patients were much/extremely improved, CPSI (p50.0001) and BFI were significantly improved (p50.0001) and laxative use decreased. No differences were found between patients 565 years vs those !65 years. OXN was generally well tolerated.
Study limitations:Study limitations including the retrospective observational design, the lack of a control group and the single-centre design may limit the generalizability of our findings.
Conclusions:Low-dose OXN (25.0 AE 12.5 mg/day) added to anticonvulsants was highly effective in controlling noncancer NP of varied aetiology, with reduced need for rescue analgesia and improved quality of sleep, and was well tolerated, with improved bowel function and reduced laxative use. The efficacy and tolerability of OXN demonstrated in this real-world setting suggest its utility in this difficult to manage patient population.
IntroductionNeuropathic pain (NP) -''pain arising as a direct consequence of a lesion or disease affecting the somatosensory system'' according to the Special Interest Group on Neuropathic Pain (NeuPSIG) 1 -may be related to cancer or of noncancer origin, can be continuous and/or episodic (paroxysmal) and is associated with dysaesthesia, hyperalgesia and allodynia [2][3][4][5] . Although treatments for NP may provide clinically meaningful reduction in pain and improvement on a broad spectrum of domains of health-related quality of life (QoL), including mood, sleep or enjoyment of life 6 , it remains difficult to manage, poses diagnostic and therapeutic challenges and presents a significant burden to individuals and society 7,8 . Pharmacological treatment for NP includes antidepressants, anticonvulsants, topical anaesthetics, and opioids, accompanied by nonpharmacological interventions such as physical therapy, psychological and interventional approaches 7,8 . Current guidelines recommend that combinations of pharmacotherapies may be more effective than monotherapy 8,9 . There are a number of limitations of current treatment, the main one being that many patients do not receive adequate pain relief due either to a lack of willingness on...