Hydromorphone for cancer pain

Bao, Yan; Hou, Wei; Kong, Xiang Y; Yang, Liping; Jones, Katie; Xia, Jun; Bao, Hua

doi:10.1002/14651858.cd011108

Cited by 10 publications

(11 citation statements)

References 21 publications

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“…A Cochrane review found evidence that hydromorphone provides similar effect on pain management as reported for oxycodone or morphine. 85 Oxycodone and Oxymorphone Oxycodone is an opioid with agonist activity at the mu-, delta-, and kappa-opioid receptors and is available in IR and ER formulations. [86][87][88] Oxycodone is also available in combination with acetaminophen; therefore, the acetaminophen dose must be monitored for safe limits to avoid potential hepatic toxicity.…”

Section: Codeinementioning

confidence: 99%

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Swarm

Paice

Anghelescu

et al. 2019

Journal of the National Comprehensive Cancer Network

411

282

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In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and adjuvant medications, and integration of nonpharmacologic methods of cancer pain management. This selection highlights some of these changes, covering topics on management of adult cancer pain including pharmacologic interventions, nonpharmacologic interventions, and treatment of specific cancer pain syndromes. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.

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Section: Codeinementioning

confidence: 99%

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Swarm

Paice

Anghelescu

et al. 2019

Journal of the National Comprehensive Cancer Network

411

282

View full text Add to dashboard Cite

show abstract

“…27 Consider opioid switching. Switching to an alternative opioid [28][29][30][31][32] is recommended if there is inadequate pain relief or unacceptable side effects. 11,12,13,14,16,17 Evidence to support opioid switching is of moderate strength, better pain relief or reduced side effects were reported in 50% of patients who switched due to sub-optimal response to another opioid in a recent four-arm, phase-IV randomised controlled trial (RCT).…”

Section: Agree Upon a Tailored Pain Management Planmentioning

confidence: 99%

Practice review: Evidence-based and effective management of pain in patients with advanced cancer

et al. 2020

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Background: Pain of a moderate or severe intensity affects over half of patients with advanced cancer and remains undertreated in at least one-third of these patients. Aim: The aim of this study was to provide a pragmatic overview of the evidence supporting the use of interventions in pain management in advanced cancer and to identify where encouraging preliminary results are demonstrated but further research is required. Design: A scoping review approach was used to examine the evidence supporting the use of guideline-recommended interventions in pain management practice. Data sources: National or international guidelines were selected if they described pain management in adult cancer patients and were written within the last 5 years in English. The Cochrane Database of Systematic Reviews (January 2014 to January 2019) was searched for ‘cancer’ AND ‘pain’ in the title, abstract or keywords. A MEDLINE search was also made. Results: A strong opioid remains the drug of choice for treating moderate or severe pain. Bisphosphonates and radiotherapy are also effective for cancer-related bone pain. Optimal management requires a tailored approach, support for self-management and review of treatment outcomes. There is likely a role for non-pharmacological approaches. Paracetamol should not be used in patients taking a strong opioid to treat pain. Cannabis-based medicines are not recommended. Weak opioids, ketamine and lidocaine are indicated in specific situations only. Conclusion: Interventions commonly recommended by guidelines are not always supported by a robust evidence base. Research is required to evaluate the efficacy of non-steroidal anti-inflammatory drugs, anti-convulsants, anti-depressants, corticosteroids, some invasive anaesthetic techniques, complementary therapies and transcutaneous electrical nerve stimulation.

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“…Although opioids such as morphine are used for the treatment of advanced bone cancer pain, an increasing dose of morphine is required . Given that the side effects caused by a higher dose of morphine, the development of a novel strategy to enhance the analgesic effects of morphine to control bone cancer pain and further to reduce its side effects also becomes an important issue for treatment and management of patients with advanced bone cancer …”

mentioning

confidence: 99%

Engagement of signaling pathways of protease-activated receptor 2 and μ-opioid receptor in bone cancer pain and morphine tolerance

et al. 2015

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Pain is one of the most common and distressing symptoms suffered by patients with progression of cancer. Using a rat model of bone cancer, recent findings suggest that proteinase-activated receptor 2 (PAR2) signaling pathways contribute to neuropathic pain and blocking PAR2 amplifies antinociceptive effects of systemic morphine. The purpose of our study was to examine the underlying mechanisms responsible for the role of PAR2 in regulating bone cancer-evoked pain and the tolerance of systemic morphine. Breast sarcocarcinoma Walker 256 cells were implanted into the tibia bone cavity of rats and this evoked significant mechanical and thermal hyperalgesia. Our results showed that the protein expression of PAR2 and its downstream pathways (protein kinases namely, PKCe and PKA) and transient receptor potential vanilloid 1 (TRPV1) were amplified in the dorsal horn of the spinal cord of bone cancer rats compared to control rats. Blocking spinal PAR2 by using FSLLRY-NH2 significantly attenuated the activities of PKCe/PKA signaling pathways and TRPV1 expression as well as mechanical and thermal hyperalgesia. Also, inhibition of PKCe/PKA and TRPV1 significantly diminished the hyperalgesia observed in bone cancer rats. Additionally, blocking PAR2 enhanced the attenuations of PKCe/PKA and cyclic adenosine monophosphate induced by morphine and further extended analgesia of morphine via l-opioid receptor (MOR). Our data revealed specific signaling pathways, leading to bone cancer pain, including the activation of PAR2, downstream PKCe/PKA, TRPV1 and resultant sensitization of MOR. Targeting one or more of these signaling molecules may present new opportunities for treatment and management of bone cancer pain often observed in clinics.Pain is one of the most common and distressing symptoms suffered by patients with progression of cancer.

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Hydromorphone for cancer pain

Cited by 10 publications

References 21 publications

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Practice review: Evidence-based and effective management of pain in patients with advanced cancer

Engagement of signaling pathways of protease-activated receptor 2 and μ-opioid receptor in bone cancer pain and morphine tolerance

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