Predictors of Reduced Opioid Use With Spinal Cord Stimulation in Patients With Chronic Opioid Use

Dougherty, Mark C.; Woodroffe, Royce W.; Wilson, Saul; Gillies, G. T.; Howard, Matthew A.; Carnahan, Ryan M.

doi:10.1111/ner.13054

Cited by 17 publications

(17 citation statements)

References 22 publications

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“…We also observed that approximately 50% of patients decreased their opioid dose, and 15.9% discontinued all opioids by 12 months postimplant placement. This is consistent with several studies demonstrating the effectiveness of neuromodulation being associated with sustained decreases in pain severity scores and opioid consumption over time (18,22,23). However, at the time of this manuscript, the authors are unaware of prior randomized controlled trials or observational studies that described opioid consumption in patients who experienced burst stimulation for treatment of chronic, intractable pain.…”

Section: Discussionsupporting

confidence: 92%

Neuromodulation With Burst and Tonic Stimulation Decreases Opioid Consumption: A Post Hoc Analysis of the Success Using Neuromodulation With BURST (SUNBURST) Randomized Controlled Trial

D’Souza¹,

Strand

2021

Neuromodulation: Technology at the Neural Interface

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Section: Discussionsupporting

confidence: 92%

Neuromodulation With Burst and Tonic Stimulation Decreases Opioid Consumption: A Post Hoc Analysis of the Success Using Neuromodulation With BURST (SUNBURST) Randomized Controlled Trial

D’Souza¹,

Strand

2021

Neuromodulation: Technology at the Neural Interface

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“…[6][7][8][14][15][16][17][18] Opioid reduction has also been reported with conventional SCS in multiple studies including prospective, retrospective and post hoc settings. [19][20][21][22][23][24] Studies showed a significantly higher percentage of patients with SCS implants reported reduced dependence on opioids for pain management. Interestingly, SCS patients who reduced or stopped their opioid use were shown to achieve better pain relief and functional outcomes compared to patients who continued to use opioids.…”

Section: Discussionmentioning

confidence: 99%

Decreased Opioid Consumption and Durable Pain Relief in Patients Treated with 10 kHz SCS: A Retrospective Analysis of Outcomes from Single-Center

Feng

Doherty

Rotte

2021

JPR

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Background: Chronic pain is frequently treated with opioid analgesics, but there is limited evidence for efficacy for chronic use of opioids and the drugs pose significant risks to patients' physical and mental health. Spinal cord stimulation delivered at a frequency of 10,000 Hertz (10 kHz SCS) is a minimally invasive therapy with demonstrated efficacy and safety in treating chronic pain that has also been associated with decreased opioid use. Objective: To evaluate opioid reduction and pain relief in real-world cohort. Study Design: Retrospective review. Setting: Single center. Patients and Methods: Consecutive patients who were implanted with 10 kHz SCS devices from December 1, 2015, to June 30, 2020 for the treatment of chronic pain in the trunk or lower limbs were included. Changes in opioid use following 10 kHz SCS treatment were extracted from electronic medical records, and patient-reported pain relief, improvement in function and sleep were extracted from manufacturer's database. Responder rate was defined as the proportion of patients with at least 50% pain relief. Anonymised results from descriptive analysis of the data are reported. Results: At last follow-up (median 21.4 months), mean daily opioid dose fell by 48.4 morphine milligram equivalents (MME), and fewer patients used opioids. Mean pain relief in these patients was 57% ± 4%, and responder rate was 68% at last recorded follow-up. Interestingly, pain relief (66%) and responder rate (86%) were higher in patients with 1 year or more. Finally, 50% of patients reported improved sleep, and 73% reported improvement in function at last recorded follow-up after treatment with 10 kHz SCS. Conclusion: These results support 10 kHz SCS as a safe and effective treatment of chronic pain in real-world patients with secondary benefits to opioid consumption and measures of patients' quality of life.

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“…Multiple studies have indicated lower baseline opioid is a predictive factor for reduced opioid consumption in response to alternative therapies including SCS and intrathecal drug delivery. A recent retrospective analysis of insurance claim data in patients who were chronic opioid users before receiving conventional SCS showed that daily opioid doses of less than 65 MME at the start of SCS treatment were predictive of reduced opioid use in response to stimulation therapy [27]. A single-center retrospective study of patients who received low-frequency SCS for refractory neuropathic pain similarly reported that baseline opioid use of ≤30 MME daily was predictive of opioid cessation and that most responders (≥50% pain relief ) did not reduce opioid use over the course of the study [28].…”

Section: Discussionmentioning

confidence: 99%

Pain Relief and Opioid Usage in Upper Limb and Neck Pain Patients After 10-kHz Spinal Cord Stimulation Treatment: Subanalysis of USA Studies

Amirdelfan¹,

Vallejo

Benyamin

et al. 2020

Pain Manag.

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Aim: It is argued that chronic pain patients who reduce/eliminate their opioids may have compromised pain relief. This study therefore aimed to analyze if reduced opioid consumption associated with 10-kHz spinal cord stimulation adversely affected pain relief. Methods: Post hoc analysis was performed on data from two prospective studies in subjects with upper limbs and neck pain conducted in USA. Results & conclusion: A 10-kHz spinal cord stimulation treatment was associated with reduction in mean visual analog scale scores for upper limbs and neck pain and mean daily opioid consumption. Pain scores decreased in subjects who decreased opioid use and in those who maintained/increased use. Opioid reduction and pain relief was also achieved in subjects taking >90 mg morphine equivalents of opioids at baseline.

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Predictors of Reduced Opioid Use With Spinal Cord Stimulation in Patients With Chronic Opioid Use

Cited by 17 publications

References 22 publications

Neuromodulation With Burst and Tonic Stimulation Decreases Opioid Consumption: A Post Hoc Analysis of the Success Using Neuromodulation With BURST (SUNBURST) Randomized Controlled Trial

Neuromodulation With Burst and Tonic Stimulation Decreases Opioid Consumption: A Post Hoc Analysis of the Success Using Neuromodulation With BURST (SUNBURST) Randomized Controlled Trial

Decreased Opioid Consumption and Durable Pain Relief in Patients Treated with 10 kHz SCS: A Retrospective Analysis of Outcomes from Single-Center

Pain Relief and Opioid Usage in Upper Limb and Neck Pain Patients After 10-kHz Spinal Cord Stimulation Treatment: Subanalysis of USA Studies

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