AI Article Synopsis
- The study investigates predictors of how well cancer neuropathic pain (CNP) patients respond to duloxetine, a medication that has shown some efficacy for this type of pain.
- Seventy patients intolerant to opioid-pregabalin therapy were randomized to receive either duloxetine or a placebo; predictors for response were analyzed using multiple linear regression.
- Results indicated that patients exhibiting higher levels of tingling pain (measured by a specific survey item) at the start of the study were likely to experience greater pain relief from duloxetine.
Article Abstract
Purpose: Duloxetine has some effect against cancer neuropathic pain (CNP); however, predictors of duloxetine response are unclear. This study sought to identify predictors of duloxetine response in patients with CNP.
Methods: Patients (N = 70) with CNP unresponsive to or intolerant of opioid-pregabalin combination therapy, with a brief pain inventory-short form (BPI-SF) Item 5 score (average pain) ≥ 4, and with a total hospital anxiety and depression scale score < 20, were randomized to a duloxetine or a placebo group. Multiple linear regression analysis was conducted to identify predictors of duloxetine response as a secondary analysis with the change in the average pain score on day 10 from day 0 as the dependent variable, and the following five covariates; baseline (day 0) average pain score, baseline opioid dose, continuation/discontinuation of pregabalin, and items 20 and 21 score of the short-form McGill pain questionnaire 2 (SF-MPQ-2) as independent variables.
Results: Of the four domains (continuous pain, intermittent pain, neuropathic pain, and affective descriptors) score of SF-MPQ-2 on day 0, significant differences were observed in the neuropathic pain domain (p = 0.040) in change on the average pain between day 10 and day 0 in the duloxetine group. Multiple linear regression analysis revealed that patients with a high score for SF-MPQ-2 Item 21 (tingling pain) on day 0 had a significantly greater change in average pain between day 10 and day 0 (p = 0.046).
Conclusion: Patients with a high score for SF-MPQ-2 Item 21 might benefit more from duloxetine.
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| http://dx.doi.org/10.1007/s00520-019-05138-9 | DOI Listing |
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