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Erschienen in: Supportive Care in Cancer 10/2012

01.10.2012 | Short Communication

Controlled-release oxycodone for the treatment of bortezomib-induced neuropathic pain in patients with multiple myeloma

verfasst von: Claudio Cartoni, Gregorio Antonio Brunetti, Vincenzo Federico, Fabio Efficace, Sara Grammatico, Andrea Tendas, Laura Scaramucci, Luca Cupelli, Gianna Maria D’Elia, Andrea Truini, Pasquale Niscola, Maria Teresa Petrucci

Erschienen in: Supportive Care in Cancer | Ausgabe 10/2012

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Abstract

Purpose

Bortezomib, a proteasome inhibitor drug very effective against multiple myeloma, may induce the so-called bortezomib-induced peripheral neuropathy (BIPN), hardly manageable with common analgesic drugs. This study assessed the effectiveness of controlled-release (CR) oral oxycodone in controlling pain and its interference on daily functions of patients with hematologic malignancies affected by BIPN.

Methods

Forty-six patients (median age, 62 years) affected by myeloma and lymphoma, complaining of BIPN-related pain of moderate-to-severe intensity and unresponsive to previous analgesic treatments, were treated with CR oxycodone. The intensity of continuous and brief pain (BP) along with interference of pain with the common daily dimensions of feeling and function were evaluated by using an 11-point numerical rating scale (NRS); a global patient evaluation of efficacy was also performed.

Results

The daily average dose of CR oxycodone administered was 28.46 mg (range, 20–80 mg). The pain intensity decreased from a mean NRS value of 7.6 at baseline to 1.3 on day 14. The frequency of BP was reduced from 61 to 47 % of patients and its intensity from 7.4 to 3.1 NRS score. A similar trend to decreasing values was observed for all the daily life functions. Slight- or mild-intensity side effects were observed in 23 patients (51 %). At the end of the study, 75 % of patients found the treatment effective or very effective.

Conclusion

CR oxycodone for relief of BIPN-related pain was effective and well tolerated. The pain control significantly improved also the quality of the daily life functions, which are usually compromised in these suffering patients.
Literatur
1.
Zurück zum Zitat Niscola P, Cartoni C, Romani C, Brunetti GA, D'Elia GM, Cupelli L, Tendas A, de Fabritiis P, Mandelli F, Foà R (2007) Epidemiology, features and outcome of pain in patients with advanced hematological malignancies followed in a home care program: an Italian survey. Ann Hematol 86(9):671–676PubMedCrossRef Niscola P, Cartoni C, Romani C, Brunetti GA, D'Elia GM, Cupelli L, Tendas A, de Fabritiis P, Mandelli F, Foà R (2007) Epidemiology, features and outcome of pain in patients with advanced hematological malignancies followed in a home care program: an Italian survey. Ann Hematol 86(9):671–676PubMedCrossRef
2.
Zurück zum Zitat Niscola P, Arcuri E, Giovannini M, Scaramucci L, Romani C, Palombi F, Trapè G, Morabito F (2004) Pain syndromes in haematological malignancies: an overview. Hematol J 5(4):293–303PubMedCrossRef Niscola P, Arcuri E, Giovannini M, Scaramucci L, Romani C, Palombi F, Trapè G, Morabito F (2004) Pain syndromes in haematological malignancies: an overview. Hematol J 5(4):293–303PubMedCrossRef
3.
Zurück zum Zitat Niscola P, Romani C, Cartoni C, Cupelli L, Piccioni D, Dentamaro T, Tendas A, Giovannini M, Scaramucci L, Tolu B, Perrotti AP, de Fabritiis P (2008) Epidemiology of pain in hospital haematological setting: an Italian survey. Leuk Res 32(1):197–198PubMedCrossRef Niscola P, Romani C, Cartoni C, Cupelli L, Piccioni D, Dentamaro T, Tendas A, Giovannini M, Scaramucci L, Tolu B, Perrotti AP, de Fabritiis P (2008) Epidemiology of pain in hospital haematological setting: an Italian survey. Leuk Res 32(1):197–198PubMedCrossRef
4.
Zurück zum Zitat Jensen TS, Gottrup H, Sindrup SH, Bach FW (2001) The clinical picture of neuropathic pain. Eur J Pharamacol 429:1–11CrossRef Jensen TS, Gottrup H, Sindrup SH, Bach FW (2001) The clinical picture of neuropathic pain. Eur J Pharamacol 429:1–11CrossRef
5.
Zurück zum Zitat Chaudhry V, Cornblath DR, Polydefkis M, Ferguson A, Borrello I (2008) Characteristics of bortezomib- and thalidomide-induced peripheral neuropathy. J Peripher Nerv Syst 13(4):275–282PubMedCrossRef Chaudhry V, Cornblath DR, Polydefkis M, Ferguson A, Borrello I (2008) Characteristics of bortezomib- and thalidomide-induced peripheral neuropathy. J Peripher Nerv Syst 13(4):275–282PubMedCrossRef
6.
Zurück zum Zitat Argyriou AA, Iconomou G, Kalofonos HP (2008) Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature. Blood 112(5):1593–1599PubMedCrossRef Argyriou AA, Iconomou G, Kalofonos HP (2008) Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature. Blood 112(5):1593–1599PubMedCrossRef
7.
Zurück zum Zitat Richardson PG, Briemberg H, Jagannath S, Wen PY, Barlogie B, Berenson J, Singhal S, Siegel DS, Irwin D, Schuster M, Srkalovic G, Alexanian R, Rajkumar SV, Limentani S, Alsina M, Orlowski RZ, Najarian K, Esseltine D, Anderson KC, Amato AA (2006) Frequency, characteristics, and reversibility of peripheral neuropathy during treatment of advanced multiple myeloma with bortezomib. J Clin Oncol 24(19):3113–3120PubMedCrossRef Richardson PG, Briemberg H, Jagannath S, Wen PY, Barlogie B, Berenson J, Singhal S, Siegel DS, Irwin D, Schuster M, Srkalovic G, Alexanian R, Rajkumar SV, Limentani S, Alsina M, Orlowski RZ, Najarian K, Esseltine D, Anderson KC, Amato AA (2006) Frequency, characteristics, and reversibility of peripheral neuropathy during treatment of advanced multiple myeloma with bortezomib. J Clin Oncol 24(19):3113–3120PubMedCrossRef
8.
Zurück zum Zitat San Miguel JF, Schlag R, Khuageva NK (2008) Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med 359:906–917PubMedCrossRef San Miguel JF, Schlag R, Khuageva NK (2008) Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med 359:906–917PubMedCrossRef
9.
Zurück zum Zitat Gerecitano J, Portlock C, Moskowitz C, Hamlin P, Straus D, Zelenetz AD, Zhang Z, Dumitrescu O, Sarasohn D, Lin D, Pappanicholaou J, Cortelli BM, Neylon E, Hamelers R, Wright J, O'Connor OA (2009) Phase 2 study of weekly bortezomib in mantle cell and follicular lymphoma. Br J Haematol 146(6):652–655PubMedCrossRef Gerecitano J, Portlock C, Moskowitz C, Hamlin P, Straus D, Zelenetz AD, Zhang Z, Dumitrescu O, Sarasohn D, Lin D, Pappanicholaou J, Cortelli BM, Neylon E, Hamelers R, Wright J, O'Connor OA (2009) Phase 2 study of weekly bortezomib in mantle cell and follicular lymphoma. Br J Haematol 146(6):652–655PubMedCrossRef
10.
Zurück zum Zitat Cavaletti G, Gilardini A, Canta A, Rigamonti L, Rodriguez-Menendez V, Ceresa C, Marmiroli P, Bossi M, Oggioni N, D'Incalci M, De Coster R (2007) Bortezomib-induced peripheral neurotoxicity: a neurophysiological and pathological study in the rat. Exp Neurol 204(1):317–325PubMedCrossRef Cavaletti G, Gilardini A, Canta A, Rigamonti L, Rodriguez-Menendez V, Ceresa C, Marmiroli P, Bossi M, Oggioni N, D'Incalci M, De Coster R (2007) Bortezomib-induced peripheral neurotoxicity: a neurophysiological and pathological study in the rat. Exp Neurol 204(1):317–325PubMedCrossRef
11.
Zurück zum Zitat Cata JP, Weng HR, Burton AW, Villareal H, Giralt S, Dougherty PM (2007) Quantitative sensory findings in patients with bortezomib-induced pain. J Pain 8(4):296–306PubMedCrossRef Cata JP, Weng HR, Burton AW, Villareal H, Giralt S, Dougherty PM (2007) Quantitative sensory findings in patients with bortezomib-induced pain. J Pain 8(4):296–306PubMedCrossRef
12.
Zurück zum Zitat Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 29;70(18):1630–1635CrossRef Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW, Hansson P, Hughes R, Nurmikko T, Serra J (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 29;70(18):1630–1635CrossRef
13.
Zurück zum Zitat Cavaletti G, Nobile-Orazio E (2007) Bortezomib-induced peripheral neurotoxicity: still far from a painless gain. Haematologica 92(10):1308–1310PubMedCrossRef Cavaletti G, Nobile-Orazio E (2007) Bortezomib-induced peripheral neurotoxicity: still far from a painless gain. Haematologica 92(10):1308–1310PubMedCrossRef
14.
Zurück zum Zitat Jagannath S, Durie BG, Wolf JL, Camacho ES, Irwin D, Lutzky J, McKinley M, Potts P, Gabayan AE, Mazumder A, Crowley J, Vescio R (2009) Extended follow-up of a phase 2 trial of bortezomib alone and in combination with dexamethasone for the frontline treatment of multiple myeloma. Br J Haematol 146(6):619–626PubMedCrossRef Jagannath S, Durie BG, Wolf JL, Camacho ES, Irwin D, Lutzky J, McKinley M, Potts P, Gabayan AE, Mazumder A, Crowley J, Vescio R (2009) Extended follow-up of a phase 2 trial of bortezomib alone and in combination with dexamethasone for the frontline treatment of multiple myeloma. Br J Haematol 146(6):619–626PubMedCrossRef
15.
Zurück zum Zitat Richardson PG, Sonneveld P, Schuster MW, Stadtmauer EA, Facon T, Harousseau JL, Ben-Yehuda D, Lonial S, Goldschmidt H, Reece D, Bladé J, Boccadoro M, Cavenagh JD, Boral AL, Esseltine DL, Wen PY, Amato AA, Anderson KC, San Miguel J (2009) Reversibility of symptomatic peripheral neuropathy with bortezomib in the phase III APEX trial in relapsed multiple myeloma: impact of a dose-modification guideline. Br J Haematol 144(6):895–903PubMedCrossRef Richardson PG, Sonneveld P, Schuster MW, Stadtmauer EA, Facon T, Harousseau JL, Ben-Yehuda D, Lonial S, Goldschmidt H, Reece D, Bladé J, Boccadoro M, Cavenagh JD, Boral AL, Esseltine DL, Wen PY, Amato AA, Anderson KC, San Miguel J (2009) Reversibility of symptomatic peripheral neuropathy with bortezomib in the phase III APEX trial in relapsed multiple myeloma: impact of a dose-modification guideline. Br J Haematol 144(6):895–903PubMedCrossRef
16.
Zurück zum Zitat Attal N, Cruccu G, Haanpää M, Hansson P, Jensen TS, Nurmikko T, Sampaio C, Sindrup S, Wiffen P, EFNS Task Force (2006) EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol 13(11):1153–1169PubMedCrossRef Attal N, Cruccu G, Haanpää M, Hansson P, Jensen TS, Nurmikko T, Sampaio C, Sindrup S, Wiffen P, EFNS Task Force (2006) EFNS guidelines on pharmacological treatment of neuropathic pain. Eur J Neurol 13(11):1153–1169PubMedCrossRef
17.
Zurück zum Zitat Dworkin RH, O’Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede RD, Turk DC, Wallace MS (2007) Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain 132:237–251PubMedCrossRef Dworkin RH, O’Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede RD, Turk DC, Wallace MS (2007) Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain 132:237–251PubMedCrossRef
18.
Zurück zum Zitat Jensen TS, Madsen CS, Finnerup NB (2009) Pharmacology and treatment of neuropathic pains. Curr Opin Neurol 22(5):467–474PubMedCrossRef Jensen TS, Madsen CS, Finnerup NB (2009) Pharmacology and treatment of neuropathic pains. Curr Opin Neurol 22(5):467–474PubMedCrossRef
19.
Zurück zum Zitat Watson CP, Babul N (1998) Efficacy of oxycodone in neuropathic pain: a randomized trial in postherpetic neuralgia. Neurology 50(6):1837–1841PubMedCrossRef Watson CP, Babul N (1998) Efficacy of oxycodone in neuropathic pain: a randomized trial in postherpetic neuralgia. Neurology 50(6):1837–1841PubMedCrossRef
20.
Zurück zum Zitat Watson CP, Moulin D, Watt-Watson J, Gordon A, Eisenhoffer J (2003) Controlled-release oxycodone relieves neuropathic pain: a randomized controlled trial in painful diabetic neuropathy. Pain 105(1–2):71–78PubMedCrossRef Watson CP, Moulin D, Watt-Watson J, Gordon A, Eisenhoffer J (2003) Controlled-release oxycodone relieves neuropathic pain: a randomized controlled trial in painful diabetic neuropathy. Pain 105(1–2):71–78PubMedCrossRef
21.
Zurück zum Zitat Niscola P, Perrotti AP, del Poeta G, Romani C, Palombi M, Piccioni D, Scaramucci L, Tolu B, Tendas A, Cupelli L, Abruzzese E, D'Elia GM, Brunetti GA, Maurillo L, Giovannini M, Cartoni C, de Fabritiis P (2007) Case reports: zoster pain in haematological malignancies: effective pain relief with oxycodone in patients unresponsive to other analgesic measures. Herpes 14(2):45–47PubMed Niscola P, Perrotti AP, del Poeta G, Romani C, Palombi M, Piccioni D, Scaramucci L, Tolu B, Tendas A, Cupelli L, Abruzzese E, D'Elia GM, Brunetti GA, Maurillo L, Giovannini M, Cartoni C, de Fabritiis P (2007) Case reports: zoster pain in haematological malignancies: effective pain relief with oxycodone in patients unresponsive to other analgesic measures. Herpes 14(2):45–47PubMed
22.
Zurück zum Zitat Gatti A, Sabato AF, Occhioni R, Colini Baldeschi G, Reale C (2009) Controlled-release oxycodone and pregabalin in the treatment of neuropathic pain: results of a multicenter Italian study. Eur Neurol 61(3):129–137PubMedCrossRef Gatti A, Sabato AF, Occhioni R, Colini Baldeschi G, Reale C (2009) Controlled-release oxycodone and pregabalin in the treatment of neuropathic pain: results of a multicenter Italian study. Eur Neurol 61(3):129–137PubMedCrossRef
24.
Zurück zum Zitat Gilardini A, Marmiroli P, Cavaletti G (2008) Proteasome inhibition: a promising strategy for treating cancer, but what about neurotoxicity? Curr Med Chem 15:3025–3035PubMedCrossRef Gilardini A, Marmiroli P, Cavaletti G (2008) Proteasome inhibition: a promising strategy for treating cancer, but what about neurotoxicity? Curr Med Chem 15:3025–3035PubMedCrossRef
25.
Zurück zum Zitat Bercovitch M, Adunsky A (2006) High dose controlled-release oxycodone in hospice care. J Pain Palliat Care Pharmacother 20(4):33–39PubMedCrossRef Bercovitch M, Adunsky A (2006) High dose controlled-release oxycodone in hospice care. J Pain Palliat Care Pharmacother 20(4):33–39PubMedCrossRef
26.
Zurück zum Zitat Niscola P, Scaramucci L, Romani C, Giovannini M, Maurillo L, del Poeta G, Cartoni C, Arcuri E, Amadori S, De Fabritiis P (2006) Opioids in pain management of blood-related malignancies. Ann Hematol 85(8):489–501PubMedCrossRef Niscola P, Scaramucci L, Romani C, Giovannini M, Maurillo L, del Poeta G, Cartoni C, Arcuri E, Amadori S, De Fabritiis P (2006) Opioids in pain management of blood-related malignancies. Ann Hematol 85(8):489–501PubMedCrossRef
Metadaten
Titel
Controlled-release oxycodone for the treatment of bortezomib-induced neuropathic pain in patients with multiple myeloma
verfasst von
Claudio Cartoni
Gregorio Antonio Brunetti
Vincenzo Federico
Fabio Efficace
Sara Grammatico
Andrea Tendas
Laura Scaramucci
Luca Cupelli
Gianna Maria D’Elia
Andrea Truini
Pasquale Niscola
Maria Teresa Petrucci
Publikationsdatum
01.10.2012
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 10/2012
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1511-y

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