Switching to low-dose oral prolonged-release oxycodone/naloxone from WHO-step i drugs in elderly patients with chronic pain at high risk of early opioid discontinuation

Marzia Lazzari, Claudio Marcassa, Silvia Natoli, Roberta Carpenedo, Clarissa Caldarulo, Maria B. Silvi, Mario Dauri

Research output: Contribution to journalArticle

Abstract

Purpose: Chronic pain has a high prevalence in the aging population. Strong opioids also should be considered in older people for the treatment of moderate to severe pain or for pain that impairs functioning and the quality of life. This study aimed to assess the efficacy and safety of the direct switch to low-dose strong opioids (World Health Organization-Step III drugs) in elderly, opioid-naive patients. Patients and methods: This was a single-center, retrospective, observational study in opioid-naive patients aged ≥75 years, with moderate to severe chronic pain (>6-month duration) and constipation, who initiated treatment with prolonged-release oxycodone/naloxone (OXN-PR). Patients were re-evaluated after 15, 30, and 60 days (T60, final observation). Response to treatment was defined as an improvement in pain of ≥30% after 30 days of therapy without worsening of constipation. Results: One-hundred and eighty-six patients (mean ± SD age 80.7±4.7 years; 64.5% women) with severe chronic pain (mean average pain intensity 7.1±1.0 on the 11-point numerical rating scale) and constipation (mean Bowel Function Index 64.1±24.4; 89.2% of patients on laxatives) were initiated treatment with OXN-PR (mean daily dose 11.3±3.5 mg). OXN-PR reduced pain intensity rapidly and was well tolerated; 63.4% of patients responded to treatment with OXN-PR. At T60 (mean daily OXN-PR dose, 21.5±9.7 mg), the pain intensity was reduced by 66.7%. In addition, bowel function improved (mean decrease of Bowel Function Index from baseline to T60, −28.2, P

Original languageEnglish
Pages (from-to)641-649
Number of pages9
JournalClinical Interventions in Aging
Volume11
DOIs
Publication statusPublished - May 13 2016

Keywords

  • Chronic pain
  • Elderly
  • Naloxone
  • Opioid
  • Oxycodone

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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