PMID- 35710811
OWN - NLM
STAT- MEDLINE
DCOM- 20220620
LR  - 20220817
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 12
IP  - 1
DP  - 2022 Jun 16
TI  - Oxycodone/naloxone versus tapentadol in real-world chronic non-cancer pain 
      management: an observational and pharmacogenetic study.
PG  - 10126
LID - 10.1038/s41598-022-13085-5 [doi]
LID - 10126
AB  - Tapentadol (TAP) and oxycodone/naloxone (OXN) potentially offer an improved 
      opioid tolerability. However, real-world studies in chronic non-cancer pain 
      (CNCP) remain scarce. Our aim was to compare effectiveness and security in daily 
      pain practice, together with the influence of pharmacogenetic markers. An 
      observational study was developed with ambulatory test cases under TAP (n = 194) 
      or OXN (n = 175) prescription with controls (prescribed with other opioids 
      (control), n = 216) CNCP patients. Pain intensity and relief, quality of life, 
      morphine equivalent daily doses (MEDD), concomitant analgesic drugs, adverse 
      events (AEs), hospital frequentation and genetic variants of OPRM1 (rs1799971, 
      A118G) and COMT (rs4680, G472A) genes, were analysed. Test CNCP cases evidenced a 
      significantly higher pain relief predictable due to pain intensity and quality of 
      life (R(2) = 0.3), in front of controls. Here, OXN achieved the greatest pain 
      relief under a 28% higher MEDD, 8-13% higher use of pregabalin and duloxetine, 
      and 23% more prescription change due to pain, compared to TAP. Whilst, TAP 
      yielded a better tolerability due the lower number of 4 [0-6] AEs/patient, in 
      front of OXN. Furthermore, OXN COMT-AA homozygotes evidenced higher rates of 
      erythema and vomiting, especially in females. CNCP real-world patients achieved 
      higher pain relief than other traditional opioids with a better tolerability for 
      TAP. Further research is necessary to clarify the potential influence of COMT and 
      sex on OXN side-effects.
CI  - (c) 2022. The Author(s).
FAU - Barrachina, Jordi
AU  - Barrachina J
AD  - Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical 
      Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
FAU - Margarit, Cesar
AU  - Margarit C
AD  - Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical 
      Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
AD  - Pain Unit, Department of Health of Alicante - General Hospital, Alicante, Spain.
FAU - Muriel, Javier
AU  - Muriel J
AD  - Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical 
      Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
AD  - Pain Unit, Department of Health of Alicante - General Hospital, Alicante, Spain.
FAU - Lopez-Gil, Santiago
AU  - Lopez-Gil S
AD  - Occupational Observatory, Miguel Hernandez University of Elche, Alicante, Spain.
FAU - Lopez-Gil, Vicente
AU  - Lopez-Gil V
AD  - Occupational Observatory, Miguel Hernandez University of Elche, Alicante, Spain.
FAU - Vara-Gonzalez, Amaya
AU  - Vara-Gonzalez A
AD  - Occupational Observatory, Miguel Hernandez University of Elche, Alicante, Spain.
FAU - Planelles, Beatriz
AU  - Planelles B
AD  - Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical 
      Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
AD  - Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernandez 
      University of Elche, Elche, Spain.
FAU - Inda, Maria-Del-Mar
AU  - Inda MD
AD  - Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical 
      Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
FAU - Morales, Domingo
AU  - Morales D
AD  - Operations Research Centre, Miguel Hernandez University of Elche, Elche, Spain.
FAU - Peiro, Ana M
AU  - Peiro AM
AD  - Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical 
      Research (ISABIAL-FISABIO Foundation), Alicante, Spain. peiro_ana@gva.es.
AD  - Department of Pharmacology, Paediatrics and Organic Chemistry, Miguel Hernandez 
      University of Elche, Elche, Spain. peiro_ana@gva.es.
AD  - Clinical Pharmacology Unit, Department of Health of Alicante - General Hospital, 
      Alicante, Spain. peiro_ana@gva.es.
AD  - Neuropharmacology on Pain (NED) Research Group, Hospital General Universitario de 
      Alicante, C/Pintor Baeza, 12, 03010, Alicante, Spain. peiro_ana@gva.es.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220616
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Drug Combinations)
RN  - 36B82AMQ7N (Naloxone)
RN  - 76I7G6D29C (Morphine)
RN  - CD35PMG570 (Oxycodone)
RN  - H8A007M585 (Tapentadol)
SB  - IM
MH  - Analgesics, Opioid/adverse effects
MH  - *Cancer Pain/drug therapy/genetics
MH  - *Chronic Pain/chemically induced/drug therapy/genetics
MH  - Constipation/drug therapy
MH  - Delayed-Action Preparations
MH  - Drug Combinations
MH  - Female
MH  - Humans
MH  - Morphine/adverse effects
MH  - Naloxone/adverse effects
MH  - Oxycodone/adverse effects
MH  - Pharmacogenomic Testing
MH  - Quality of Life
MH  - Tapentadol
PMC - PMC9203709
COIS- The authors declare no competing interests.
EDAT- 2022/06/18 06:00
MHDA- 2022/06/22 06:00
PMCR- 2022/06/16
CRDT- 2022/06/17 00:14
PHST- 2022/01/09 00:00 [received]
PHST- 2022/05/20 00:00 [accepted]
PHST- 2022/06/17 00:14 [entrez]
PHST- 2022/06/18 06:00 [pubmed]
PHST- 2022/06/22 06:00 [medline]
PHST- 2022/06/16 00:00 [pmc-release]
AID - 10.1038/s41598-022-13085-5 [pii]
AID - 13085 [pii]
AID - 10.1038/s41598-022-13085-5 [doi]
PST - epublish
SO  - Sci Rep. 2022 Jun 16;12(1):10126. doi: 10.1038/s41598-022-13085-5.