Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

von Moos, Roger, Body, Jean-Jacques, Egerdie, Blair, Stopeck, Alison, Brown, Janet, Fallowfield, Lesley, Patrick, DonaldL, Cleeland, Charles, Damyanov, Danail, Palazzo, FelipeSalvador, Marx, Gavin, Zhou, Ying, Braun, Ada, Balakumaran, Arun and Qian, Yi (2015) Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases. Suportive care in Cancer. pp. 1-11. ISSN 0941-4355

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Abstract

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning.METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm.RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function.CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning.

Item Type: Article
Additional Information: Support Care Cancer
Keywords: Skeletal-related events (SREs) Denosumab Zoledronic acid Pain Brief Pain Inventory (BPI) Analgesic Quantification Algorithm (AQA)
Schools and Departments: Brighton and Sussex Medical School > Sussex Health Outcomes Research & Education in Cancer (SHORE-C)
Subjects: R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology Including cancer and carcinogens
Depositing User: Kathryn Monson
Date Deposited: 07 Sep 2015 14:36
Last Modified: 15 Mar 2017 03:23
URI: http://sro.sussex.ac.uk/id/eprint/56589

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