Oxycodone in the long-term treatment of chronic pain related to scleroderma skin ulcers.

Abstract

OBJECTIVE:

To demonstrate the efficacy and safety of long-term therapy with oxycodone in severe pain of scleroderma skin ulcers.

DESIGN:

Open study.

SETTING AND PATIENTS:

Twenty-nine consecutive patients, referred to our Rheumatology Unit during 2006, affected by systemic sclerosis complicated by painful long-standing skin ulcers entered in the study. In all cases, pain was classified as severe according to World Health Organization guidelines, and oxycodone chloridrate (Oxycontin®; Mundipharma Pharmaceuticals, Milan, Italy) was administrated at the dosage of 10-20mg twice daily for a mean period of 7.9±3.2 standard deviation months.

OUTCOME MEASURES:

To evaluate the efficacy and safety of opioid therapy, the following parameters were recorded at standard time intervals: visual analog scale (VAS) pain, Pittsburgh sleep quality index (PSQI), hours of sleep per night, Health Assessment Questionnaire-Disability index, analgesics use (rescue therapy), side effects, vital signs, routine laboratory assessment.

RESULTS:

After 1 month of therapy, all patients experienced relief of pain (VAS decreased from 93.8±8.72 to 56.7±10.4, P<0.0001), and better quality of sleep (total hours of sleep increased from 3.68±1.28 to 5.27±0.75, P<0.0001; PSQI decreased from 9.72±3.95 to 3.37±1.04, P<0.0001). These parameters further improved after 3 months of therapy and remained stable during the follow-up; moreover, an increase of daily dosage of oxycodone was never required. The observed side effects were always transient and mild; only constipation, when present, was persistent.

CONCLUSION:

Oxycodone showed to be effective and safe in the treatment of pain due to severe scleroderma skin ulcers; contemporarily, it markedly improved the patient's compliance to local wound care procedures.

• Authors: Dilia Giuggioli, Andreina Manfredi, Michele Colaci, Clodoveo Ferri
• Journal: Pain medicine (Malden, Mass.) (Pain Med) Vol. 11 Issue 10 Pg. 1500-3 (Oct 2010) ISSN: 1526-4637 [Electronic] England
• PMID: 20456083 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Wiley Periodicals, Inc.

Chemical References

• Analgesics, Opioid
• Oxycodone

Topics

• Analgesics, Opioid (adverse effects, therapeutic use)
• Debridement
• Disability Evaluation
• Dose-Response Relationship, Drug
• Female
• Humans
• Long-Term Care
• Male
• Middle Aged
• Oxycodone (adverse effects, therapeutic use)
• Pain (drug therapy, etiology)
• Pain Measurement
• Patient Compliance
• Scleroderma, Localized (complications, therapy)
• Skin Ulcer (complications, therapy)
• Surveys and Questionnaires