Reumatizam, Vol. 63 No. 1, 2016.
Preliminary communication
CONTROLLED-RELEASE OXYCODONE IN THE TREATMENT OF CHRONIC MUSCULOSKELETAL PAIN: A PRELIMINARY EXPERIENCE OF A RHEUMATOLOGY CENTER
Simeon Grazio
Frane Grubišić
Vladimir Knež
Hana Skala Kavanagh
Tomislav Nemčić
Abstract
In the etiology of non-malignant pain, a signifi cant proportion is constituted by patients with pain
originatng in the musculoskeletal system. Th e use of strong opioids in the treatment of non-malignant pain is still
controversial. Th erefore, the aim of this study was to establish the effi cacy and safety of oxycodone with a controlled
release of the active substance (CR) in the treatment of patients with chronic, not well-controlled musculoskeletal pain.
Here we present our preliminary results.
In this prospective, open, single-center study conducted at a rheumatology center we enrolled consecutive patients
with musculoskeletal pain due to a variety of musculoskeletal diseases (osteoarthritis, pain in the lower back, spondyloarthritis),
who suff ered from moderate to severe pain despite previous analgesic therapy (with NSAIDs, weak opioids,
or a fi xed combination of paracetamol and weak opioids). Patients were switched to therapy with oxycodone CR and
followed for 14 days. Th e starting dose of oxycodone CR was 10 mg, and later the dose was adapted as necessary. Th e
primary endpoint was to assess the eff ectiveness of oxycodone CR on pain intensity, and the secondary goal was
to assess the effi ciency on the general health of the patient (both on a horizontal visual analogue scale, VAS 0 = best,
10 = worst). Fift een patients (12 women, 3 men), with a mean age of 61 ± 12 years and a diagnosis of osteoarthritis,
pain in the lower back, or infl ammatory arthritis, were included in the study. Th e duration of pain was 41 ± 12 months.
Th e average intensity of pain before oxycodone CR treatment was 7.87 ± 2.28 (range 7-10), and at the end of the study
it was 5.92 ± 2.43 (range 4-9) (p=0.069). General health was rated 7.27 ± 2.14 (range 3-10) before the start and 6.00 ±
1.53 (range 3-9) at the end of the study (p=0.028). In one patient the treatment was discontinued due to dizziness and
nausea, and one patient voluntarily left the study because of fear and the subjective impression of no adequate pain
control aft er 2 days of treatment. Th e oxycodone side-eff ect profi le was as expected.
Results of our preliminary study show that in patients with chronic non-malignant pain which is not well controlled
by simple analgesics, NSAIDs, and weak opioids, treatment with oxycodone CR contributed to a signifi cant
reduction in the level of pain and improved the general health of the subjects.
Keywords
Musculosceletal pain – etiology, drug therapy; Chronic pain – etiology, drug therapy; Oxycodone – therapeutic use, administration and dosage; Analgesics, opioid – therapeutic use, administration and dosage; Delayedaction preparations – therapeutic use; Pain measurement; Quality of life; Prospective studies
Hrčak ID:
182810
URI
Publication date:
10.5.2016.
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