title: Double-blind evaluation of analgesic efficacy of orally administered diclofenac, nefopam, and acetylsalicylic acid (ASA) plus codeine in chronic cancer pain.
abstract: The analgesic efficacy and toxicity of oral diclofenac sodium 50 mg (q.i.d.) vs. nefopam 60 mg (q.i.d.) and a combination of 640 mg ASA and 40 mg codeine (q.i.d.) in cancer patients with moderate to severe chronic pain has been evaluated in a randomized double-blind study. Planned duration of treatment was 10 days. Pain intensity was evaluated by a visual analog scale. The length of patient participation in the trial, the patient's final global evaluation and the incidence of side effects were also evaluated. Ninety-nine patients were enrolled in the study. All treatments produced a statistically significant pain relief (P less than 0.01) without differences among groups but only 26 of 99 patients (26.3%) completed the planned treatment period. Mean time in the study was 4.65 days. Inefficacy and side effects were the main reasons for premature treatment interruption. Patients treated with nefopam had a significantly shorter period in the study than patients treated with the other 2 treatments. Adverse effects were slightly more frequent with the nefopam and ASA + codeine regimens. The 3 therapeutic regimens appear to be similar as to analgesic efficacy, but diclofenac presents the advantage of a slightly better safety profile than nefopam and the ASA + codeine combination.
authors.affiliation: Division of Medical Oncology, Policlinico, 06100 PerugiaItaly Institute of Internal Medicine I, University of Perugia, 06100 PerugiaItaly Institute of Anesthesiology, University of Perugia, 06100 PerugiaItaly Medical Department Ciba-Geigy, Origgio, 21040 VareseItaly.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Minotti
authors.forename: Lucio
authors.initials: L
authors.lastname: Patoia
authors.forename: Fausto
authors.initials: F
authors.lastname: Roila
authors.forename: Carlo
authors.initials: C
authors.lastname: Basurto
authors.forename: Maurizio
authors.initials: M
authors.lastname: Tonato
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pasqualucci
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Maresca
authors.forename: Albano
authors.initials: A
authors.lastname: Del Favero
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003061:Codeine / Q000009:adverse effects / Q000627:therapeutic use; D004008:Diclofenac / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009340:Nefopam / Q000009:adverse effects / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy*; D010352:Patient Dropouts
chemical_list: D000700:Analgesics; D004338:Drug Combinations; D004008:Diclofenac; D009340:Nefopam; D001241:Aspirin; D003061:Codeine