Prolonged-release oxycodone/naloxone in the treatment of neuropathic pain - results from a large observational study.
OBJECTIVE
Opioids have shown consistent efficacy in neuropathic pain, but opioid-induced bowel dysfunction is a relevant problem. In controlled clinical trials, a fixed-dose combination of prolonged-release (PR) oxycodone/PR naloxone was superior to oxycodone alone in bowel function, while providing effective analgesia. The present report is an analysis of its efficacy and safety in a subgroup of patients with severe chronic neuropathic pain who were treated in a large observational study under real-life conditions.


METHODS
Dosed according to pain severity, 1488 patients with chronic severe neuropathic pain received PR oxycodone/PR naloxone for up to 4 weeks. Variables included pain severity, patient-reported bowel function (Bowel Function Index; BFI) and quality of life.


RESULTS
During treatment with PR oxycodone/PR naloxone, mean pain intensity decreased in opioid-naive and opioid-pretreated patients. After 4 weeks on treatment, mean BFI scores were reduced from 41.6 ± 31.6 at the initiation visit to 16.5 ± 19.6 (p < 0.001), reflecting normal bowel function. Quality of life was improved by 47%.


CONCLUSIONS
Treatment of severe neuropathic pain with PR oxycodone/PR naloxone provided effective analgesia with the added benefit of favorable effects on bowel function and quality of life.
Regionales Schmerzzentrum Berlin Prenzlauer Berg der DGS e.V , Ostseestr. 107, 10409 Berlin , Germany. kai.hermanns@dgschmerztherapie.de
Kai
K
Hermanns
Uwe
U
Junker
Thomas
T
Nolte
D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy*; D003248:Constipation / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D003672:Defecation / Q000187:drug effects*; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000009:adverse effects / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D009437:Neuralgia / Q000175:diagnosis / Q000188:drug therapy*; D010098:Oxycodone / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D009292:Narcotic Antagonists; C557247:oxycodone naloxone combination; D009270:Naloxone; D010098:Oxycodone