Clin Orthop Surg.  2018 Mar;10(1):33-40. 10.4055/cios.2018.10.1.33.

Analgesic Efficacy and Safety of Prolonged-Release Oxycodone/Naloxone in Korean Patients with Chronic Pain from Spinal Disorders

Affiliations
  • 1Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sungsoo.chung@samsung.com
  • 3Department of Orthopaedic Surgery, Dong-A University Hospital, Busan, Korea.
  • 4Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Orthopedic Surgery, Seoul Spine Institute, Inje University Sanggye Paik Hospital, Seoul, Korea.
  • 7Department of Orthopaedic Surgery, Inha University Hospital, Incheon, Korea.
  • 8Department of Orthopaedic Surgery, Chungnam National University Hospital, Daejeon, Korea.
  • 9Department of Orthopaedic Surgery, Chungbuk National University Hospital, Cheongju, Korea.
  • 10Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
  • 11Mundipharma Korea Ltd., Seoul, Korea.

Abstract

BACKGROUND
A prolonged-release formulation of oxycodone/naloxone has been shown to be effective in European populations for the management of chronic moderate to severe pain. However, no clinical data exist for its use in Korean patients. The objective of this study was to assess efficacy and safety of prolonged-release oxycodone/naloxone in Korean patients for management of chronic moderate-to-severe pain.
METHODS
In this multicenter, single-arm, open-label, phase IV study, Korean adults with moderate-to-severe spinal disorder-related pain that was not satisfactorily controlled with weak opioids and nonsteroidal anti-inflammatory drugs received prolonged-release oral oxycodone/naloxone at a starting dose of 10/5 mg/day (maximum 80/40 mg/day) for 8 weeks. Changes in pain intensity and quality of life (QoL) were measured using a numeric rating scale (NRS, 0-10) and the Korean-language EuroQol-five dimensions questionnaire, respectively.
RESULTS
Among 209 patients assessed for efficacy, the mean NRS pain score was reduced by 25.9% between baseline and week 8 of treatment (p < 0.0001). There was also a significant improvement in QoL from baseline to week 8 (p < 0.0001). The incidence of adverse drug reactions was 27.7%, the most common being nausea, constipation, and dizziness; 77.9% of these adverse drug reactions had resolved or were resolving at the end of the study.
CONCLUSIONS
Prolonged-release oxycodone/naloxone provided significant and clinically relevant reductions in pain intensity and improved QoL in Korean patients with chronic spinal disorders. (ClinicalTrials.gov identifier: NCT01811238)

Keyword

Spine; Chronic pain; Analgesia; Oxycodone naloxone combination

MeSH Terms

Adult
Analgesia
Analgesics, Opioid
Chronic Pain*
Constipation
Dizziness
Drug-Related Side Effects and Adverse Reactions
Humans
Incidence
Nausea
Quality of Life
Spine
Analgesics, Opioid

Figure

  • Fig. 1 Patient disposition. ITT: intention-to-treat.

  • Fig. 2 The plot shows mean pain intensity score (numeric rating scale [NRS]) at baseline and at weeks 4 and 8. The values shown in each bar represent the mean ± standard deviation score. *Statistically significant changes in pain intensity scores were observed after treatment with the study drug.

  • Fig. 3 The plot shows mean scores at baseline and at week 8 for EuroQol-five dimensions questionnaire (EQ-5D, A) and EQ-visual analogue scale (EQ-VAS, B). The values shown in each bar represent the mean ± standard deviation score.


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