Continuous Intrathecal Infusion of Ziconotide for Treatment of Chronic Malignant and Nonmalignant Pain Over 12 Months: A Prospective, Open-label Study

Ellis, David; Dissanayake, Sanjeeva; McGuire, Dawn; Charapata, Steven G.; Staats, Peter S.; Wallace, Mark; Grove, Gene W.; Vercruysse, Piet

doi:10.1111/j.1525-1403.2007.00141.x

Cited by 49 publications

(52 citation statements)

References 36 publications

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“…Adverse effects such as somnolence, confusion, urinary incontinence, and fever were more common with ziconotide than placebo but were easily recognized and decreased when the dose of ziconotide was decreased. A long-term follow-up of open-label ziconotide [40] showed significant improvement in pain intensity scores from baseline at all time points and past 12 months.…”

Section: Comparisons Of Different Intraspinal Medicationsmentioning

confidence: 88%

Intraspinal techniques for pain management in cancer patients: a systematic review

Myers

Chan

Jarvis

et al. 2009

Support Care Cancer

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Section: Comparisons Of Different Intraspinal Medicationsmentioning

confidence: 88%

Intraspinal techniques for pain management in cancer patients: a systematic review

Myers

Chan

Jarvis

et al. 2009

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“…It has a narrow therapeutic window, and has demonstrated in numerous prospective studies to be helpful in treating malignant and nonmalignant chronic pain [12][13][14][15][16][17].…”

Section: Introduction To the Compoundmentioning

confidence: 99%

Ziconotide: a clinical update and pharmacologic review

Pope¹,

Deer

2013

Expert Opinion on Pharmacotherapy

127

110

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Ziconotide is a safe and effective strategy to treat chronic pain, although limitations remain, including a small therapeutic window. Low starting doses and slow incremental increases and long titration intervals may improve tolerability. AEs may be mitigated by also employing combination therapy, although further study is needed. Concomitant use of ziconotide and morphine is an option when considering use of FDA-labeled intrathecal drugs in those resistant to monotherapy.

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“…Obwohl 88% der Patienten über Nebenwirkungen, wie Verwirrtheit (42%), Übelkeit (30%), Nystagmus (23%), Ganganomalien (16%) und Gedächt-nisstörungen (13%) litten, waren 40,4% der Patienten sehr bis ausgezeichnet mit dem Behandlungsergebnis zufrieden. Ellis et al [5] beobachteten mit der Therapie zufriedene Patienten über 12 trathekale Gabe von Morphin. Wir befürwor-ten bei neuropathischen Gesichtsschmerzen einen Behandlungsversuch mit Zikonotid nach Ausschöpfung der leitlinienbasierten Therapien, wobei in der Testphase nach einer Startdosis von 0,6-1,2 µg/Tag die Dosiserhöhung um 0,6 µg/Tag pro Woche zur Vermeidung von zentralen Nebenwirkungen geboten scheint.…”

Section: Erfahrungen Mit Intrathekaler First-line-therapie Mit Ziconounclassified

“…In der Literatur findet die intrathekale Therapie mit Ziconotid bei (neuropathischen) Schmerzen im Bereich der Hirnnerven mit Ausnahme einer Fallpublikation keinen Niederschlag [10]. Die Wirksamkeit von Ziconotid wird in mehreren Publikationen bei neuropathischem und zentralem Schmerz beschrieben [16,22], wobei aber nicht erkennbar ist, inwieweit Patienten mit (neuropathischen) Gesichtsschmerzen in die Studien eingeschlossen worden sind [5,15,23]. Michiels et al [13] [20].…”

Section: Tab 3 Fall 3: Veränderungen Im Therapieverlaufunclassified

Erfahrungen mit intrathekaler First-line-Therapie mit Ziconotide bei Patienten mit neuropathischen Gesichtsschmerzen

Lux

Rasche

2011

Schmerz

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We report on the intrathecal use of ziconotide in three patients with idiopathic facial pain after surgery of the mouth, jaw or face and one patient with neuropathic pain after damage of the lingual nerve. The therapy was successful in three patients but one patient with idiopathic facial pain had pain relief only during the test phase of ziconotide with an external pump and not after implanting the Synchromed® pump. With intrathecal morphine therapy this patient achieved good pain relief. We recommend that patients with neuropathic facial pain should be treated with ziconotide after implementation of guideline-based therapy. In the test phase the ziconotide dose should be increased by 0.6 µg/day per week after an initial dose of 0.6-1.2 µg/day to avoid side-effects.

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Continuous Intrathecal Infusion of Ziconotide for Treatment of Chronic Malignant and Nonmalignant Pain Over 12 Months: A Prospective, Open-label Study

Cited by 49 publications

References 36 publications

Intraspinal techniques for pain management in cancer patients: a systematic review

Intraspinal techniques for pain management in cancer patients: a systematic review

Ziconotide: a clinical update and pharmacologic review

Erfahrungen mit intrathekaler First-line-Therapie mit Ziconotide bei Patienten mit neuropathischen Gesichtsschmerzen

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