Metamizole/dipyrone for the relief of cancer pain: A systematic review and evidence-based recommendations for clinical practice

Gaertner, Jan; Stamer, Ulrike; Rémi, Constanze; Voltz, Raymond; Bausewein, Claudia; Sabatowski, Rainer; Wirz, Stefan; Müller-Mundt, Gabriele; Simon, Steffen T.; Pralong, Anne; Nauck, Friedemann; Follmann, Markus; Radbruch, Lukas; Meißner, Winfried

doi:10.1177/0269216316655746

Cited by 57 publications

(51 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This improvement in the mefenamic group could be explained by the treatment with NSAIDS and the consequent decrease in baseline pain levels. According to a recent study, a decrease in pain levels is associated with an improvement in quality of life (66). However, in the present study, there was no statistically significant difference between the baseline and final pain levels measured by the EQ-5D-5L, which is why the effect observed was perhaps not due to a decrease in pain level.…”

Section: Time -------------------------------------------------------contrasting

confidence: 89%

Decreased biochemical progression in patients with castration‑resistant prostate cancer using a novel mefenamic acid anti‑inflammatory therapy: A randomized controlled trial

et al. 2020

View full text Add to dashboard Cite

Prostate cancer (PCa) is the second most common non-dermatological cancer in men and is a growing public health problem. Castration-resistant disease (CRD) is the most advanced stage of the disease and is difficult to control. Patients with CRD may no longer accept conventional therapies as they are not in appropriate clinical conditions or they refuse to receive it. Given that inflammation is an essential component of CRD origin and progression, anti-inflammatory agents could be a therapeutic option with fenamates as one of the proposed choices. A prospective, randomized, double-blinded, 2-arm, parallel group, phase II-III clinical trial was performed involving 20 patients with CRD-PCa (with a prostate specific antigen level <100 ng/ml) that were undergoing androgen deprivation therapy (ADT) and did not accept any established treatment for that disease stage. In addition to ADT, 10 patients received placebo and 10 received mefenamic acid (500 mg orally every 12 h) for 6 months. The primary endpoint was the change in serum prostate-specific antigen (PSA) at 6 months. The PSA levels decreased significantly with mefenamic acid (an average 42% decrease), whereas there was an average 55% increase in the placebo group (P=0.024). In the patients treated with the placebo, 70% had biochemical disease progression (an increase of ≥25% in PSA levels), which did not occur in any of the patients treated with mefenamic acid (relative risk= 0.12; 95% confidence interval, 0.01-0.85; P= 0.033). There was a significant increase in quality of life (EQ-5D-5L score) and body mass index (BMI) with the experimental treatment. In conclusion, mefenamic acid administration decreased biochemical progression in patients with castration resistant PCa, improved their quality of life and increased their BMI. Future studies are required in order to strengthen the findings of the present clinical trial. Trial registration, Cuban Public Registry of Clinical Trials Database RPCEC00000248,

show abstract

Section: Time -------------------------------------------------------contrasting

confidence: 89%

Decreased biochemical progression in patients with castration‑resistant prostate cancer using a novel mefenamic acid anti‑inflammatory therapy: A randomized controlled trial

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In some prospective trials analyzing the analgesic use of metamizole, preexisting liver injury was defined as an exclusion criterion. In 2017, Gaertner et al performed a systematic review evaluating the application of metamizole for relief of cancer pain. They analyzed 4 studies (3 randomized controlled trials and 1 cohort study with a total of 252 patients) revealing a favorable toxicity profile without any hepatotoxic effects.…”

Section: Potential Hepatotoxicity Associated With the Use Of Metamizolementioning

confidence: 99%

“…Nearly 100 years have passed since metamizole, also known as dipyrone, was introduced to the market in 1922. 1,2 Due to its chemical structure belonging to the class of pyrazolones and its analgesic, antipyretic, and (however weak) antiphlogistic effects, metamizole is classified as a nonsteroidal anti-inflammatory drug (NSAID). [3][4][5] Compared to the other agents of this heterogeneous group, metamizole also offers additional spasmolytic properties.…”

mentioning

confidence: 99%

Metamizole (Dipyrone) and the Liver: A Review of the Literature

Lutz

2019

The Journal of Clinical Pharma

View full text Add to dashboard Cite

Metamizole, also known as dipyrone, was introduced to the market nearly a century ago. Due to its excellent analgesic, antipyretic, and spasmolytic properties combined with its mostly favorable gastrointestinal tolerability, the drug was extensively applied worldwide during the first decades after its market introduction. Although rare, agranulocytosis is a well‐known adverse event of metamizole and led to its withdrawal from the market in a number of countries beginning in the 1960s. Nevertheless, metamizole is still a frequently used drug worldwide either legally (by prescription in some countries, over the counter in other countries) or without official approval (especially by immigrants knowing the drug from their home countries) or even illegally (due to its growing application as an adulterant in illicit drugs). Metamizole undergoes extensive metabolism in the liver and cases of potential metamizole‐associated hepatotoxicity have been described. Here, the literature is extensively reviewed for the first time regarding hepatic effects associated with the use of metamizole.

show abstract

“…Th e analgesic eff ect of metamizole seems to be based on the inhibition of cyclooxygenase (COX) enzyme activity, predominantly COX enzyme type 2 [1]. Also, this is the base for its antipyretic eff ects [5,6]. Th ere is the an assumption that metamizole might be an inhibitor of the COX-3 isoenzyme, wich thereby reduces prostaglandin synthesis in the dorsal horn of the spinal cord [7].…”

Section: Mechanism Of Actionmentioning

confidence: 99%

Metamizole: Current status of the safety and efficacy

Miljković¹,

Rančić²,

Simić³

et al. 2018

Hosp Pharm Int Multi J

View full text Add to dashboard Cite

Metamizole is a nonsteroidal anti-infl ammatory drug, with analgesic, antipyretic, spasmolytic, and weak anti-infl ammatory properties. The analgesic eff ect of metamizole seems to be based on the inhibition of cyclooxygenase enzyme activity and stimulation of cannabinoid receptors. Its use is still controversial, mainly due to agranulocytosis, metamizole-induced serious adverse reaction. While in many countries it is withdrawn from the market, in some countries metamizole is available as a medication prescribed for strictly defi ned indications, while in the others like Mexico, Brazil and China it can be obtained as an Over-The-Counter drug. The most common adverse eff ects of metamizole are the skin and subcutaneous tissue disorders. Metamizole appears to be of similar effi cacy to analgesics which are frequently used in the treatment of moderate to severe postoperative pain.

show abstract

Metamizole/dipyrone for the relief of cancer pain: A systematic review and evidence-based recommendations for clinical practice

Cited by 57 publications

References 38 publications

Decreased biochemical progression in patients with castration‑resistant prostate cancer using a novel mefenamic acid anti‑inflammatory therapy: A randomized controlled trial

Decreased biochemical progression in patients with castration‑resistant prostate cancer using a novel mefenamic acid anti‑inflammatory therapy: A randomized controlled trial

Metamizole (Dipyrone) and the Liver: A Review of the Literature

Metamizole: Current status of the safety and efficacy

Contact Info

Product

Resources

About