NOTICIAS DIARIAS

Study Suggests: Continuous Subcutaneous Infusion Of Parecoxib Could Reduce Cancer Pain

Anaesthesiology

New research reported that continuous subcutaneous parecoxib could reduce cancer pain in hospice patients. After parecoxib administration, pain scores and the number of required rescue opioid doses were considerably decreased. It could also replace oral NSAIDs when required.

Peter Armstrong from the Belfast Health and Social Care Trust in Belfast, UK, and associates reviewed data on 80 cancer inpatients (mean age, 62; 57% men) who received a continuous subcutaneous infusion of parecoxib (2008-2013).

The parecoxib was administered for the mean duration of 17.9 days (median, 11 days).The most common cancer diagnoses were lung (20%), colorectal (14%), prostate (11%), and breast (10%).

In the group, 55% participants had metastatic bone pain, 16% had non-malignant pain, 13% had mixed pain, 6% visceral pain, and 10% had unknown pain.

During the administration of parecoxib, 63% of patients still received opioids. The parecoxib (nonsteroidal anti-inflammatory drug) was well tolerated. But, some patients reported adverse effects of the drug, such as local site reactions (n=15), reductions in renal function (n=11), and dyspepsia (n=8). Thirty-two patients had at least one adverse effect.  

The drug was continued among 46% patients until death in the hospice, and 24% patients were discharged on the drug. In 24 patients, Parecoxib was discontinued since12 patients had adverse effects of the drug; seven patients switched to an oral nonsteroidal anti-inflammatory drug and lack of efficacy in 5 patients.

After one week of parecoxib administration, pain scores and the number of required rescue opioid doses were considerably decreased. However, an opioid-sparing effect of the drug was not found.

Dr. Susan LeGrand, director of education at the Harry R. Horvitz Center for Palliative Medicine said, “This was essentially a study on the ability to safely give parecoxib by continuous subcutaneous infusion.”

The retrospective study’s outcomes should not change patient management, said Dr. LeGrand. However, continuous subcutaneous injection of parecoxib could replace oral NSAIDs when required, she added. 

She highlighted that it was impossible to determine the best approach to mix the medications since the method of infusion (saline vs. water) was altered during the study. “This is a proof-of-concept study,” she said. It would be difficult to conduct a randomized trial in patients who could no longer speak, she added.  

Researcher reported that continuous subcutaneous parecoxib could reduce cancer pain in hospice patients. After parecoxib administration, pain scores and the number of required rescue opioid doses were considerably decreased. It could also replace oral NSAIDs when required.