Injectable Ketoprofen VS. Acetylsalicylic Acid for the Relief of Severe Cancer Pain: A Double-Blind, Crossover Trial

Sacchetti, G; Camera, P. Della; Rossi, Andrea; Martoni, Andrea; Bruni, Giancarlo; Pannuti, F

doi:10.1177/106002808401800510

Cited by 13 publications

(15 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We screened 5991 publications, of which 43 met the inclusion criteria after full‐text review ( Figure ) . We excluded 30 studies (Supporting Information, S4).…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis on non‐opioid analgesics in palliative medicine

Schüchen

Mücke

Marinova

et al. 2018

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

Non‐opioid analgesics are widely used for pain relief in palliative medicine. However, there is a lack of evidence‐based recommendations addressing the efficacy, tolerability, and safety of non‐opioids in this field. A comprehensive systematic review and meta‐analysis on current evidence can provide a basis for sound recommendations in clinical practice. A database search for controlled trials on the use of non‐opioids in adult palliative patients was performed in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, and EMBASE from inception to 18 February 2018. Endpoints were pain intensity, opioid‐sparing effects, safety, and quality of life. Studies with similar patients, interventions, and outcomes were included in the meta‐analyses. Our systematic search was able to only identify studies dealing with cancer pain. Of 5991 retrieved studies, 43 could be included (n = 2925 patients). There was no convincing evidence for satisfactory pain relief by acetaminophen alone or in combination with strong opioids. We found substantial evidence of moderate quality for a satisfactory pain relief in cancer by non‐steroidal anti‐inflammatory drugs (NSAIDs), flupirtine, and dipyrone compared with placebo or other analgesics. There was no evidence for a superiority of one specific non‐opioid. There was moderate quality of evidence for a similar pain reduction by NSAIDs in the usual dosage range compared with up to 15 mg of morphine or opioids of equianalgesic potency. The combination of NSAID and step III opioids showed a beneficial effect, without a decreased tolerability. There is scarce evidence concerning the combination of NSAIDs with weak opioids. There are no randomized‐controlled studies on the use of non‐opioids in a wide range of end‐stage diseases except for cancer. Non‐steroidal anti‐inflammatory drugs, flupirtine, and dipyrone can be recommended for the treatment of cancer pain either alone or in combination with strong opioids. The use of acetaminophen in the palliative setting cannot be recommended. Studies are not available for long‐term use. There is a lack of evidence regarding pain treatment by non‐opioids in specific cancer entities.

show abstract

“…We screened 5991 publications, of which 43 met the inclusion criteria after full‐text review ( Figure ) . We excluded 30 studies (Supporting Information, S4).…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis on non‐opioid analgesics in palliative medicine

Schüchen

Mücke

Marinova

et al. 2018

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

show abstract

“…Four studies enrolled patients with either malignant bone pain, non-bone malignant pain, or both, but results were not reported separately for bone-related and non-bone-related pain in any study. Three studies [25][26][27] examined the analgesic efficacy of NSAIDs specifically for malignant bone pain, but not for other types of malignant pain. Analgesic efficacy data were extractable from only two of these studies, but were not combinable because one was a single-dose trial [27] and the other a multiple-dose trial [25].…”

Section: Anti-inflammatory Agentsmentioning

confidence: 99%

“…Three studies [25][26][27] examined the analgesic efficacy of NSAIDs specifically for malignant bone pain, but not for other types of malignant pain. Analgesic efficacy data were extractable from only two of these studies, but were not combinable because one was a single-dose trial [27] and the other a multiple-dose trial [25]. The single-dose with ketoprofen study crossover reported a mean NSAID-induced PPID of 40% to 55% and SPID of 34% to 45%.…”

Section: Anti-inflammatory Agentsmentioning

confidence: 99%

Painful Boney Metastases

Smith

Barkin

2014

American Journal of Therapeutics

View full text Add to dashboard Cite

Boney metastasis may lead to terrible suffering from debilitating pain. The most likely malignancies that spread to bone are prostate, breast, and lung. Painful osseous metastases are typically associated with multiple episodes of breakthrough pain which may occur with activities of daily living, weight bearing, lifting, coughing, and sneezing. Almost half of these breakthrough pain episodes are rapid in onset and short in duration and 44% of episodes are unpredictable. Treatment strategies include: analgesic approaches with "triple opioid therapy", bisphosphonates, chemotherapeutic agents, hormonal therapy, interventional and surgical approaches, steroids, radiation (external beam radiation, radiopharmaceuticals), ablative techniques (radiofrequency ablation, cryoablation), and intrathecal analgesics. (Korean J Pain 2013; 26: 223-241)

show abstract

“…Four studies enrolled patients with either malignant bone pain, non-bone malignant pain, or both, but results were not reported separately for bone-related and non-bone-related pain in any study. Three studies [25-27] examined the analgesic efficacy of NSAIDs specifically for malignant bone pain, but not for other types of malignant pain. Analgesic efficacy data were extractable from only two of these studies, but were not combinable because one was a single-dose trial [27] and the other a multiple-dose trial [25].…”

Section: Anti-inflammatory Agentsmentioning

confidence: 99%

“…Three studies [25-27] examined the analgesic efficacy of NSAIDs specifically for malignant bone pain, but not for other types of malignant pain. Analgesic efficacy data were extractable from only two of these studies, but were not combinable because one was a single-dose trial [27] and the other a multiple-dose trial [25]. The single-dose with ketoprofen study crossover reported a mean NSAID-induced PPID of 40% to 55% and SPID of 34% to 45%.…”

Section: Anti-inflammatory Agentsmentioning

confidence: 99%