Is acetaminophen beneficial in patients with cancer pain who are on strong opioids? A randomized controlled trial

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dc.catalogadorcrc
dc.contributor.authorLeiva, Ofelia
dc.contributor.authorLetelier Saavedra, Luz María
dc.contributor.authorRojas Orellana, Luis
dc.contributor.authorViviani García, Paola
dc.contributor.authorCastellano, Joel
dc.contributor.authorGonzález Candia, Antonio Felipe
dc.contributor.authorPérez Cruz, Pedro
dc.date.accessioned2023-06-07T17:05:46Z
dc.date.available2023-06-07T17:05:46Z
dc.date.issued2023
dc.description.abstractContextPain is common among cancer patients. The evidence recommends using strong opioids in moderate to severe cancer pain. No conclusive evidence supports the effectiveness of adding acetaminophen to patients with cancer pain who are already using this regime.ObjectiveTo assess the analgesic efficacy of acetaminophen in hospitalized cancer patients with moderate to severe pain receiving strong opioids.MethodsIn this randomized blinded clinical trial, hospitalized cancer patients with moderate or severe acute pain managed with strong opioids were randomized to acetaminophen or placebo. The primary outcome was pain intensity difference between baseline and 48 hours using the Visual Numeric Rating Scales (VNRS). Secondary outcomes included change in morphine equivalent daily dose (MEDD), and patients’ perception of improved pain control.ResultsAmong 112 randomized patients, 56 patients received placebo, 56 acetaminophen. Mean (standard deviation (SD)) decrease in pain intensity (VNRS) at 48 hours were 2.7 (2.5) and 2.3 (2.3), respectively (95% Confidence Interval(CI) [-0.49;1.32];p=0.37). Mean (SD) change in MEDD was 13.9 (33.0) mg/day and 22.4 (57.7), respectively (95% CI [-9.24;26.1];p=0.35). The proportion of patients perceiving pain control improvement after 48 hours was 82% in the placebo and 80% in the acetaminophen arms (p=0.81).ConclusionAmong patients with cancer pain on strong opioid regime, acetaminophen may not improve pain control, or decrease total opioid use. These results add to the current evidence available suggesting not to use acetaminophen as an adjuvant for advanced cancer patients with moderate to severe cancer pain who are on strong opioids.
dc.fechaingreso.objetodigital2023-06-06
dc.fuente.origenORCID
dc.identifier.citationOfelia Leiva-Vasquez , Luz M. Letelier , Luis Rojas , Paola Viviani , ´Joel Castellano , Antonio Gonzalez , Pedro E. P ´ erez-Cruz , Is acetaminophen beneficial in patients ´with cancer pain who are on strong opioids? A randomized controlled trial, Journal of Pain and Symp tom Management (2023), doi: https://doi.org/10.1016/j.jpainsymman.2023.05.002
dc.identifier.doi10.1016/j.jpainsymman.2023.05.002
dc.identifier.eissn1873-6513
dc.identifier.issn0885-3924
dc.identifier.urihttps://doi.org/10.1016/j.jpainsymman.2023.05.002
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/70546
dc.information.autorucEscuela de medicina; Leiva, Ofelia; 0000-0001-8136-3505; 167303
dc.information.autorucEscuela de medicina ; Letelier Saavedra, Luz María ; 000-0002-4150-2985; 52245
dc.information.autorucEscuela de Medicina; Rojas Orellana, Luis; 0000-0002-0234-5876; 135613
dc.information.autorucFacultad de Matemáticas; Viviani García, Paola; 0000-0003-2886-5228; 729
dc.information.autorucEscuela de Medicina; Castellano, Joel; 0000-0001-9051-6892; 1020225
dc.information.autorucEscuela de Medicina; Gonzalez Candia, Antonio Felipe; 0000-0001-9512-3481; 149421
dc.information.autorucEscuela de Medicina; Perez Cruz, Pedro; 0000-0001-6265-6919; 4140
dc.language.isoen
dc.nota.accesoContenido parcial
dc.revistaJournal of Pain and Symptom Management
dc.rightsacceso restringido
dc.subjectCáncer pain
dc.subjectPalliative care
dc.subjectAcetaminophen
dc.subjectStrong opioids
dc.subjectRandomized
dc.subjectControlled trial
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleIs acetaminophen beneficial in patients with cancer pain who are on strong opioids? A randomized controlled trial
dc.typepreprint
sipa.codpersvinculados167303
sipa.codpersvinculados52245
sipa.codpersvinculados135613
sipa.codpersvinculados729
sipa.codpersvinculados1020225
sipa.codpersvinculados149421
sipa.codpersvinculados4140
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