The efficacy of choline magnesium trisalicylate (CMT) in the management of metastatic bone pain: a pilot study

Johnson, J G; Aj, Miller

doi:10.1177/026921639400800206

Cited by 26 publications

(18 citation statements)

References 15 publications

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“…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%

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

Schüchen

Mücke

Marinova

et al. 2018

J cachexia sarcopenia muscle

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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.

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“…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%

“…lung, breast, colorectal region, prostate, liver, blood, or skin). Pain due to bone metastases was an inclusion criterion in six studies . Approximately 50% of the studies did not specify the type and location of the pain; the remainder had various origins, for example, visceral, neuropathic, or bone.…”

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

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“…243 However, administration of a single dose of choline magnesium trisalicylate (1500 mg) was found to provide rapid relief from bone pain associated with metastatic cancer in one double-blind clinical study. 244 Whether tetrathiomolybdate, which inhibits NF-κB activation in certain cancer cells, might have a similar impact on osteocytes has not been studied.…”

Section: Slowing Osteolysismentioning

confidence: 99%

Toward a Core Nutraceutical Program for Cancer Management

McCarty

Block

2006

Integr Cancer Ther

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As previously suggested, it may be feasible to impede tumorevoked angiogenesis with a nutraceutical program composed of glycine, fish oil, epigallocatechin-3-gallate, selenium, and silymarin, complemented by a low-fat vegan diet, exercise training, and, if feasible, a salicylate and the drug tetrathiomolybdate. It is now proposed that the scope of this program be expanded to address additional common needs of cancer patients: blocking the process of metastasis; boosting the cytotoxic capacity of innate immune defenses (natural killer [NK] cells); preventing cachexia, thromboembolism, and tumor-induced osteolysis; and maintaining optimal micronutrient status. Modified citrus pectin, a galectin-3 antagonist, has impressive antimetastatic potential. Mushroom β-glucans and probiotic lactobacilli can amplify NK activity via stimulatory effects on macrophages. Selenium, β-carotene, and glutamine can also increase the number and/or cytotoxic activity of NK cells. Cachectic loss of muscle mass can be opposed by fish oil, glutamine, and β-hydroxy-β-methylbutyrate. Fish oil, policosanol, and vitamin D may have potential for control of osteolysis. High-dose aspirin or salicylates, by preventing NF-κB activation, can be expected to aid prevention of metastasis and cachexia while down-regulating osteolysis, but their impacts on innate immune defenses will not be entirely favorable. A nutritional insurance formula crafted for the special needs of cancer patients can be included in this regimen. To minimize patient inconvenience, this complex core nutraceutical program could be configured as an oil product, a powder, and a capsule product, with the nutritional insurance formula provided in tablets. It would be of interest to test this program in nude mouse xenograft models.

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“…Among the conventional NSAIDs, the non‐acetylated salicylates, including choline magnesium trisalicylate and salsalate, 28 which have lesser effects on platelet aggregation and no effect on bleeding time at the usual clinical doses, are preferred in patients with tendencies to peptic ulceration or bleeding.…”

Section: Systemic Analgesic Pharmacotherapymentioning

confidence: 99%

“…In such situations, sedation may be the only therapeutic option capable of providing adequate relief. This approach is described as “sedation in the management of refractory symptoms at the end of life.” 28 …”

Section: Invasive Analgesic Techniquesmentioning

confidence: 99%

The management of cancer pain

Cherny

2000

CA: A Cancer Journal for Clinicians

104

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(CA Cancer J Clin 2000;50: 70-116.) Pain is among the most prevalent symptoms experienced by patients with cancer.1 The success of cancer pain therapy-which depends on the ability of the clinician to assess the presenting problems, identify and evaluate pain syndromes, and formulate a plan for comprehensive continuing care-requires familiarity with a range of therapeutic options (Table 1) and an approach to longterm care that is responsive to the changing needs of the patient.The formulation of an effective therapeutic strategy for the management of pain and other symptoms is predicated on a comprehensive assessment of the patient. Such an assessment should clarify the characteristics of the pain, including its impact on function and psychological well-being; identify the pain syndrome and the putative mechanisms that may underlie the pain; define and evaluate both the nature and extent of the underlying disease; and characterize concurrent problems (physical, psychological, and social) that are contributing, or may soon contribute, to patient distress.The particular therapeutic strategy that evolves from this information depends on the goals of care. These goals can generally be grouped into three broad categories: 1) Prolonging survival, 2) optimizing comfort, and 3) optimizing function. The relative priority of these goals provides an essential context for t h e m a n a g e m e n t o f c a n c e r p a i n 70Ca-A cancer Journal for Clinicians

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The efficacy of choline magnesium trisalicylate (CMT) in the management of metastatic bone pain: a pilot study

Cited by 26 publications

References 15 publications

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

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

Toward a Core Nutraceutical Program for Cancer Management

The management of cancer pain

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