Treatment of cancer pain: Spanish Society of Medical Oncology (SEOM) recommendations for clinical practice

Virizuela, Juan Antonio; Escobar, Yolanda; Cassinello, Javier; Borrega, Pablo

doi:10.1007/s12094-012-0831-1

Cited by 35 publications

(30 citation statements)

References 17 publications

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“…The Spanish Society of Medical Oncology recently issued recommendations for the treatment of cancer pain that clearly indicate that although immediate-release morphine has been the traditional treatment for breakthrough pain, its mechanism of action does not conform to the defining characteristics of this type of pain 36. The EAPC guidelines state that oral transmucosal fentanyl formulations are more effective than immediate-release oral morphine and that intranasal fentanyl affords faster analgesia than the oral transmucosal formulation 35.…”

Section: Treatment Of Breakthrough Painmentioning

confidence: 99%

Breakthrough cancer pain – still a challenge

Margarit¹,

Juliá²,

López³

et al. 2012

JPR

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Breakthrough cancer pain is defined as transient pain exacerbation in patients with stable and controlled basal pain. Although variable, the prevalence of breakthrough cancer pain is high (33%–95%). According to the American Pain Foundation, breakthrough pain is observed in 50%–90% of all hospitalized cancer patients, in 89% of all patients admitted to homes for the elderly and terminal-patient care centers, and in 35% of all ambulatory care cancer patients. The management of breakthrough cancer pain should involve an interdisciplinary and multimodal approach. The introduction of new fentanyl formulations has represented a great advance and has notably improved treatment. Among these, the pectin-based intranasal formulation adjusts very well to the profile of breakthrough pain attacks, is effective, has a good toxicity profile, and allows for convenient dosing – affording rapid and effective analgesia with the added advantage of being easily administered by caregivers when patients are unable to collaborate.

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Section: Treatment Of Breakthrough Painmentioning

confidence: 99%

Breakthrough cancer pain – still a challenge

Margarit¹,

Juliá²,

López³

et al. 2012

JPR

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“…Opioids remain the mainstay for the treatment of cancer pain. 23,24,49 Although some studies have reported that NP may be refractory to opioids, 50,51 most recent data show that NP can be alleviated by opioids albeit at higher doses and at the price of increased AEs. 11,14,15 Furthermore, there is data supporting that opioids may be more efficacious for the treatment of peripheral compared with central NP.…”

Section: Discussionmentioning

confidence: 99%

“…16 On the other hand, certain adjuvant drugs have been shown to be useful for the treatment of NP in cancer, [17][18][19][20] and their use is included in recent guidelines and clinical recommendations, usually as add-ons to opioids. [21][22][23][24] However, head-to-head data for the comparative efficacy of opioids versus adjuvants in NCP are lacking. In patients with uncontrolled NCP, the clinician is often encountered with the question of whether to increase the opioid dose or add an adjuvant.…”

Section: Introductionmentioning

confidence: 99%

Pregabalin Vs. Opioids for the Treatment of Neuropathic Cancer Pain: A Prospective, Head‐to‐Head, Randomized, Open‐Label Study

et al. 2013

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& AbstractObjectives: Neuropathic cancer pain (NCP) is a common manifestation of cancer and/or its treatment. Treatment following the WHO analgesic ladder provides relief for the majority of cancer pain patients; however, concern remains that opioids may be less efficacious for neuropathic pain (NP) compared with nociceptive pain, often necessitating the use of higher doses. Adjuvants, such as pregabalin, have shown to be efficacious for the treatment of NP, although data come mostly from noncancer studies. The comparative efficacy and safety of opioids versus adjuvants has not been studied for NCP. The aim of this study was to directly compare pregabalin versus a strong opioid for the treatment of NCP. Methods: A total of 120 patients, diagnosed with "definite" NCP, were randomized into two groups and received increasing doses of either oral pregabalin or transdermal fentanyl for 28 days. VAS score, patient satisfaction, need for opioid rescue, and adverse events (AEs) were recorded. Results: In the pregabalin group, a significantly higher proportion of patients achieved at least 30% reduction in VAS compared with the fentanyl group (73.3%, 95% CI: 60.3%-83.93 vs. 36.7%, 95% CI: 24.5%-50.1%, P < 0.0001, respectively), while the percentage mean change from baseline was also significantly different [46% (95% CI: 39.5%-52.8%) for pregabalin and 22% (95% CI: 14.9%-29.5%) for fentanyl (P < 0.0001)]. Patient-reported satisfaction was more frequent with pregabalin, while AEs and treatment discontinuations were more frequent in the fentanyl group. Discussion: Prompt use of a neuropathic pain-specific adjuvant, such as pregabalin, in NCP may lead to better control of the neuropathic component, with opioid-sparing effects. &

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“…Pain is the main reason for consultation among patients with cancer. Pain occurs in 50% of all patients with cancer, and this fi gure may increase to 70-90% as the disease progresses [1]. The recommendations of the World Health Organization (WHO) pain management ladder should be followed for the appropriate treatment [2].…”

Section: Introductionmentioning

confidence: 99%

Clinical practice evaluation of opioids induced constipation management in patients with cancer: The EIO-50 project

Guillém¹,

Bofill²,

Feyjoo³

et al. 2019

Open J Pain Med

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Introduction:Opioid-Induced Constipation (OIC) is a common distressing symptom associated with cancer pain treatment. Consensus guidelines for management of OIC are limited and little is known about the decision making of Health Care Professionals (HCP) for the management of OIC. The aim of this study was to learn about the diagnostic and treatment criteria of OIC management in clinical practice in patients with cancer. Methods:A survey was designed with 50 OIC specifi c questions and was completed by 135 HCP: 122 medical oncologists (90.4%) and 13 palliative care specialists (9.6%).Result: OIC was considered a relevant side effect by 97% of the specialists. HCP declared differences in the characteristics of OIC depending on whether the patients were treated with major or minor opioids: the percentage of patients developing OIC (54.5% vs 29.8%), OIC intensity (severe in 17% vs 10.8%) and the time to symptoms onset in 1-4 weeks (92.6% vs 73.3%). Only 14% HCP used algorithms for the diagnosis or treatment of OIC. Healthy life-style was considered fi rst-line treatment for OIC by 85.2%. Laxatives were prescribed by 99.3% of HCP, but 32.6% of patients did not achieve a response. Peripherally Active μ-Opioid Receptor Antagonists (PAMORAs) were considered the most effective specifi c treatment of OIC. Naloxegol was the PAMORA most often used for the treatment of OIC in patients with cancer. Conclusion:The narrow effectiveness of traditional therapies and the emergence of more effective pharmacological approaches suggest the need for standardized and updated guidelines for OIC diagnosis and management in patients with cancer. 035 https://www.peertechz.com/journals/open-journal-of-pain-medicine Citation: Guillem V, Salvador Bofill FJ, Feyjoo M, Antón A, Aranda E, et al. (2019) Clinical practice evaluation of opioids induced constipation management in patients with cancer: The EIO-50 project. Open J Pain Med 3(1): 034-040. DOI: https://dx.

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Treatment of cancer pain: Spanish Society of Medical Oncology (SEOM) recommendations for clinical practice

Cited by 35 publications

References 17 publications

Breakthrough cancer pain – still a challenge

Breakthrough cancer pain – still a challenge

Pregabalin Vs. Opioids for the Treatment of Neuropathic Cancer Pain: A Prospective, Head‐to‐Head, Randomized, Open‐Label Study

Clinical practice evaluation of opioids induced constipation management in patients with cancer: The EIO-50 project

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Treatment of cancer pain: Spanish Society of Medical Oncology (SEOM) recommendations for clinical practice

Cited by 35 publications

References 17 publications

Breakthrough cancer pain &ndash; still a challenge

Breakthrough cancer pain &ndash; still a challenge

Pregabalin Vs. Opioids for the Treatment of Neuropathic Cancer Pain: A Prospective, Head‐to‐Head, Randomized, Open‐Label Study

Clinical practice evaluation of opioids induced constipation management in patients with cancer: The EIO-50 project

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Breakthrough cancer pain – still a challenge

Breakthrough cancer pain – still a challenge