Control of non-malignant chronic pain conditions in Japan and the possible future role of tramadol.
Pharmacological treatment is the most common treatment for non-malignant chronic pain diseases such as lumbar and/or cervical spondylosis and osteoarthritis of the knee or hip joint. In Japan, opioid analgesics cannot be used for non-malignant chronic pain syndromes because of the strict regulations for opioid use by the Ministry of Health and Welfare. Non-steroidal anti-inflammatory drugs (NSAIDs) do not have sufficient effect as analgesics for some painful conditions as well as having possible serious side-effects on the gastrointestinal tract and kidneys. According to the Japanese Rheumatism Foundation report on NSAID-induced gastrointestinal lesions in 1991, gastric ulcers were found in 15.5% of 1008 patients who underwent endoscopic examinations. In multicentric questionnaire research, it was discovered that 63% received NSAIDs for longer than 3 months. New drugs having stronger effects for chronic pain and less severe adverse side-effects are expected within the decade. Tramadol hydrochloride controlled-release is a long- and centrally-acting analgesic without serious side-effects for which we are currently going on to the phase II trial in collaborative studies between Japan and the United States for non-malignant chronic pain diseases.
Itoh
T
T
Department of Othopaedic Surgery, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan. office@ort.twmu.ac.jp
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002908:Chronic Disease; D004358:Drug Therapy / Q000639:trends; D006801:Humans; D007564:Japan; D010146:Pain / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D013276:Stomach Ulcer / Q000139:chemically induced; D014147:Tramadol / Q000627:therapeutic use*
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014147:Tramadol