Original Article
Controlled-Release Oxycodone Alone or Combined with Gabapentin for Management of Malignant Neuropathic Pain
Abstract
Objective: To evaluate the analgesic efficacy of controlled-release (CR) oxycodone and gabapentin in malignant neuropathic pain (NP).
Methods: Patients with malignant NP were enrolled and baseline pain intensity (PI) was recorded. They initially took one week CR oxycodone and were allocated to two different groups at day 8 by reevaluated PI. Patients with mild pain went to CR oxycodone mono-therapy group (OO group) and took another two weeks CR oxycodone. Others went to (CR oxycodone combined gabapentin group (OG group) and received additional gabapentin. Daily doses and side effects were recorded.
Results: Fifty-eight (92.06%) of the 63 enrolled patients completed the initial week’s therapy. Twenty-two (37.93%) went to OO group and PI significantly reduced at day 15 (2.00 vs. 2.62, P=0.004), but not improved at day 22 (1.90 vs. 2.00, P=0.54). Thirty-six (62.07%) patients went to OG group and PI was significantly reduced at day 15 (4.47 vs. 2.94, P<0.001), but not improved at day 22 (2.94 vs. 2.75, P=0.136). Mean daily dose (MDD) of CR oxycodone at day 8 was 62.64 mg. It was significantly increased at days 15 and 22 (71.43 mg vs. 62.64 mg, P=0.021; 81.90 mg vs. 71.43 mg, P=0.004) in OO group. MDD of gabapentin was significantly increased at day 22 compared to day 15 (862.50 mg vs. 993.75 mg, P<0.001). Constipation was occurred in 13.64% of the patients in OO group and 14.26 % in OG group.
Conclusion: Malignant NP may be well controlled by oxycodone mono-therapy. Early combination with gabapentin is sensible when pain is not satisfactory relieved by oxycodone alone. The side effects of them are manageable.
Methods: Patients with malignant NP were enrolled and baseline pain intensity (PI) was recorded. They initially took one week CR oxycodone and were allocated to two different groups at day 8 by reevaluated PI. Patients with mild pain went to CR oxycodone mono-therapy group (OO group) and took another two weeks CR oxycodone. Others went to (CR oxycodone combined gabapentin group (OG group) and received additional gabapentin. Daily doses and side effects were recorded.
Results: Fifty-eight (92.06%) of the 63 enrolled patients completed the initial week’s therapy. Twenty-two (37.93%) went to OO group and PI significantly reduced at day 15 (2.00 vs. 2.62, P=0.004), but not improved at day 22 (1.90 vs. 2.00, P=0.54). Thirty-six (62.07%) patients went to OG group and PI was significantly reduced at day 15 (4.47 vs. 2.94, P<0.001), but not improved at day 22 (2.94 vs. 2.75, P=0.136). Mean daily dose (MDD) of CR oxycodone at day 8 was 62.64 mg. It was significantly increased at days 15 and 22 (71.43 mg vs. 62.64 mg, P=0.021; 81.90 mg vs. 71.43 mg, P=0.004) in OO group. MDD of gabapentin was significantly increased at day 22 compared to day 15 (862.50 mg vs. 993.75 mg, P<0.001). Constipation was occurred in 13.64% of the patients in OO group and 14.26 % in OG group.
Conclusion: Malignant NP may be well controlled by oxycodone mono-therapy. Early combination with gabapentin is sensible when pain is not satisfactory relieved by oxycodone alone. The side effects of them are manageable.
