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


CONCLUSIONS
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.
Hematology, Department of Haematology, Oncology, Pathology and Regenerative Medicine, Policlinico Umberto I, Sapienza University Rome, Rome, Italy. cartoni@bce.uniroma1.it
Claudio
C
Cartoni
Gregorio Antonio
GA
Brunetti
Vincenzo
V
Federico
Fabio
F
Efficace
Sara
S
Grammatico
Andrea
A
Tendas
Laura
L
Scaramucci
Luca
L
Cupelli
Gianna Maria
GM
D'Elia
Andrea
A
Truini
Pasquale
P
Niscola
Maria Teresa
MT
Petrucci
D000284:Administration, Oral; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001897:Boronic Acids / Q000009:adverse effects*; D000069286:Bortezomib; D003692:Delayed-Action Preparations; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D010098:Oxycodone / Q000008:administration & dosage*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D011719:Pyrazines / Q000009:adverse effects*; D012384:Rome
D000701:Analgesics, Opioid; D000970:Antineoplastic Agents; D001897:Boronic Acids; D003692:Delayed-Action Preparations; D011719:Pyrazines; D000069286:Bortezomib; D010098:Oxycodone