scholarly journals A Comparison of the Clinical Effectiveness Between Low-Dose Strong Opioids and Non-Steroidal Anti-Inflammatory Drugs in the Treatment of Mild Cancer Pain: A Randomized Trial

2021 ◽  
Vol Volume 14 ◽  
pp. 3411-3419
Author(s):  
Mei-Zuo Liu ◽  
Jian Ma ◽  
Jun-Dong Li ◽  
Jing Sun ◽  
Hua Zhou ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Randomized Trial ◽  
Low Dose ◽  
Clinical Effectiveness ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Strong Opioids

scholarly journals Nonopioid Drugs in the Treatment of Cancer Pain

2014 ◽  
Vol 32 (16) ◽  
pp. 1677-1690 ◽  
Author(s):  
Janette Vardy ◽  
Meera Agar
Keyword(s):  
Cancer Pain ◽  
Cord Compression ◽  
Primary Objective ◽  
Limited Evidence ◽  
Who Analgesic Ladder ◽  
Sequential Approach ◽  
Analgesic Agents ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Strong Opioids

The WHO analgesic ladder for the treatment of cancer pain provides a three-step sequential approach for analgesic administration based on pain severity that has global applicability. Nonopioids were recommended for mild pain, with the addition of mild opioids for moderate pain and strong opioids for severe pain. Here, we review the evidence for the use of nonopioid analgesic agents in patients with cancer and describe the mode of action of the main drug classes. Evidence supports the use of anti-inflammatory drugs such as acetaminophen/paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) for mild cancer pain. Adding an NSAID to an opioid for stronger cancer pain is efficacious, but the risk of long-term adverse effects has not been quantified. There is limited evidence to support using acetaminophen with stronger opioids. Corticosteroids have a specific role in spinal cord compression and brain metastases, where improved analgesia is a secondary benefit. There is limited evidence for adding corticosteroids to stronger opioids when pain control is the primary objective. Systematic reviews suggest a role for antidepressant and anticonvulsant medications for neuropathic pain, but there are methodologic issues with the available studies. Bisphosphonates improve pain in patients with bony metastases in some tumor types. Denosumab may delay worsening of pain compared with bisphosphonates. Larger studies of longer duration are required to address outstanding questions concerning the use of nonopioid analgesia for stronger cancer pain.

scholarly journals Oral nonsteroidal anti-inflammatory drugs (NSAIDs) for cancer pain in adults

2017 ◽  
Author(s):  
Sheena Derry ◽  
Philip J Wiffen ◽  
R Andrew Moore ◽  
Ewan D McNicol ◽  
Rae F Bell ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Dose-dependent roles of aspirin and other non-steroidal anti-inflammatory drugs in abnormal bone remodeling and skeletal regeneration

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yong Xie ◽  
Meng Pan ◽  
Yanpan Gao ◽  
Licheng Zhang ◽  
Wei Ge ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Remodeling ◽  
Low Dose ◽  
High Dose ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Dose Dependent ◽  
High Dose Aspirin

AbstractThe failure of remodeling process that constantly regenerates effete, aged bone is highly associated with bone nonunion and degenerative bone diseases. Numerous studies have demonstrated that aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) activate cytokines and mediators on osteoclasts, osteoblasts and their constituent progenitor cells located around the remodeling area. These cells contribute to a complex metabolic scenario, resulting in degradative or synthetic functions for bone mineral tissues. The spatiotemporal effects of aspirin and NSAIDs in the bone remodeling are controversial according the specific therapeutic doses used for different clinical conditions. Herein, we review in vitro, in vivo, and clinical studies on the dose-dependent roles of aspirin and NSAIDs in bone remodeling. Our results show that low-dose aspirin (< 100 μg/mL), which is widely recommended for prevention of thrombosis, is very likely to be benefit for maintaining bone mass and qualities by activation of osteoblastic bone formation and inhibition of osteoclast activities via cyclooxygenase-independent manner. While, the roles of high-dose aspirin (150–300 μg/mL) and other NSAIDs in bone self-regeneration and fracture-healing process are difficult to elucidate owing to their dual effects on osteoclast activity and bone formation of osteoblast. In conclusion, this study highlighted the potential clinical applications of low-dose aspirin in abnormal bone remodeling as well as the risks of high-dose aspirin and other NSAIDs for relieving pain and anti-inflammation in fractures and orthopedic operations.

scholarly journals Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents

2017 ◽  
Author(s):  
Christopher Eccleston ◽  
Tess E Cooper ◽  
Emma Fisher ◽  
Brian Anderson ◽  
Nick MR Wilkinson
Keyword(s):  
Cancer Pain ◽  
Children And Adolescents ◽  
Inflammatory Drugs ◽  
Anti Inflammatory
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