Articles of interest in other scholarly journals
Cleeland CS, Body JJ, Stopeck A, von Moos R, Fallowfield L, Mathias SD, Patrick DL, Clemons M, Tonkin K, Masuda N, Lipton A, de Boer R, Salvagni S, Oliveira CT, Qian Y, Jiang Q, Dansey R, Braun A, Chung K.
The effect of denosumab versus zoledronic acid on pain, activities of daily life and need for a strong opioid were assessed in an international RCT of 2046 patients with advanced breast cancer and bone metastases. Denosumab demonstrated better pain prevention and less worsening of pain severity, with fewer patients needing a strong opioid. In patients who had no/mild pain at baseline, there was a 4-month delay in the development of moderate/severe pain with denosumab compared with zoledronic acid. However, in patients with pain, the time to pain improvement was similar with denosumab and zoledronic acid.
Mishra S, Bhatnagar S, Goyal GN, Rana SP, Upadhya SP.
120 patients with severe neuropathic cancer pain were randomised to receive amitriptyline, gabapentin, pregabalin or placebo. Oral morphine was used if pain persisted. Pregabalin decreased the pain score more than the other drugs/placebo. Reduction in burning, lancinating pain and dysesthesia was best with pregabalin and then gabapentin. All the patients taking placebo needed rescue morphine, which was needed least in those taking pregabalin. The maximum improvement in ECOG and global satisfaction score was observed with pregabalin. Although amitriptyline, gabapentin, pregabalin and morphine (incrementally dosed in the placebo group), were effective in relieving pain, there was a morphine sparing effect of pregabalin along with a reduction in neuropathic symptoms compared to amitriptyline, gabapentin and placebo. Pregabalin also had the least severe side effects.
Management of Moderate-to-Severe Dyspnea in Hospitalized Patients Receiving Palliative Care.
Gomutbutra P, O’Riordan DL, Pantilat SZ.
A 115 patients with moderate to severe dyspnoea from mixed aetiologies, had dyspnoea scores measured before and after a palliative care review. 74% had an improvement in dyspnoea, of which 42% only received opioids, 37% had opioids and benzodiazepines, 2% only received benzodiazepines, and 19% had neither. Opioids and benzodiazepines in combination were associated with improvement in dyspnoea, with most patients reported improvement in dyspnoea 1 day after palliative care review.
Compiled by Jason Boland