Oral nonsteroidal anti-inflammatory drugs (NSAIDs) for cancer pain in adults

Derry, Sheena; Wiffen, Philip J; Moore, Richard A.; McNicol, Ewan D; Bell, Rae Frances; Carr, Daniel B.; McIntyre, Mairead; Wee, Bee

doi:10.1002/14651858.cd012638.pub2

Cited by 49 publications

(44 citation statements)

References 111 publications

(17 reference statements)

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“…However, there are reports stating that chronic aspirin consumption lowered PSA levels in patients by 5-10% at the time of PCa diagnosis, compared with patients that did not take aspirin (25,27,29). To the best of our knowledge, the mechanism by which aspirin decreases PSA levels at the time of diagnosis has not yet been determined, nor has whether that effect is associated with disease progression (56)(57)(58). Notably, in the present clinical trial, mefenamic acid was demonstrated to decrease PSA levels when administered to patients with CRD-PCa.…”

Section: Discussionmentioning

confidence: 99%

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

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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,

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Section: Discussionmentioning

confidence: 99%

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

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“…However, there was no sufficient evidence of the included records about reducing cancer-related pain in children and adolescents (72) , and no high-quality evidence to support the use of NSAIDs alone or in combination with opioids for the three step WHO cancer pain ladder (73) .…”

Section: Research Hotspotsmentioning

confidence: 99%

Trends analysis of cancer topic of Cochrane systematic reviews: a bibliometric analysis

Yang

Gao

Cai

et al. 2019

Preprint

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Purpose: To analyze the scientific outputs of the cancer topic of Cochrane systematic reviews (Cancer-CSR) in order to have a comprehensive understanding and lay the foundation for the following research. Patients and methods: Cochrane Database of Systematic Review and Web of Science Core Collection were retrieved limited from Jan. 1, 2009 to Dec. 12, 2018. CiteSpace IV and Excel 2018 were applied to analyze and visualize the literature information. Results: Ultimately, 607 Cancer-CSR were retrieved, 32 countries, 179 institutions and 260 authors involved. The number of publications in Cancer-CSR has been increasing over the past decades (25(2009)-77(2018)). UK, USA, Canada, Australia, and Germany worked closely with other countries, especially the UK (n=361) has taken the lead in this field. The top 10 contributive institutions, which were almost came from developed countries, collaborated closely with other institutions. Cochrane Database Syst Rev, C Hdb Sys and J Clin Oncol were the top three journals with the highest co-citation. The top three co-cited references were the two different version of Cochrane handbook for systematic reviews and the guidelines of Review Manager. The biggest cluster of keywords “cytoreductive surgery (CRS)” and the latest clusters “visual inspection” and “non-steroidal anti-inflammatory drug” were the most promising hotspots. Conclusions: Cancer-CSR has been increasing. Most of the reviews were came from the developed countries as well as the institutes in these countries. The knowledge base of was the methodology studies of systematic review, epidemiological data of cancer, and the reporting guideline of systematic reviews. The adjuvant therapy combined CRS, the screening of skin cancer and the management of cancer-related pain were the hotspots. Reasons that influence the author's preference for Cancer-CSR also deserve further investigation.

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“…2 The role of NSAIDs in cancer pain was assessed in a recent Cochrane review. 6 Nine of the 11 included studies had substantial risk of bias, being small and having incomplete outcome data. In four studies, NSAIDS initially reduced moderate or severe pain after 1 or 2 weeks (415 participants).…”

Section: Non-steroidal Anti-infl Ammatory Drugsmentioning

confidence: 99%

Updates in palliative care – overview and recent advancements in the pharmacological management of cancer pain

et al. 2018

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Oral nonsteroidal anti-inflammatory drugs (NSAIDs) for cancer pain in adults

Cited by 49 publications

References 111 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

Trends analysis of cancer topic of Cochrane systematic reviews: a bibliometric analysis

Updates in palliative care – overview and recent advancements in the pharmacological management of cancer pain

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