Quantitative sensory tests fairly reflect immediate effects of oxycodone in chronic low-back pain.

Schliessbach, Jürg; Siegenthaler, Andreas; Bütikofer, Lukas; Vuilleumier, Pascal Henri; Jüni, Peter; Arendt-Nielsen, Lars; Curatolo, Michele (2017). Quantitative sensory tests fairly reflect immediate effects of oxycodone in chronic low-back pain. Scandinavian journal of pain, 17, pp. 107-115. Elsevier 10.1016/j.sjpain.2017.07.004

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INTRODUCTION Quantitative sensory tests (QST) can be used for profiling anti-nociceptive effects of analgesics. However, anti-nociceptive effects detected by QST are not necessarily associated with analgesic effects in pain patients. As part of a large investigation on low back pain, this paper describes the immediate analgesic and anti-nociceptive effects of oxycodone in chronic low-back pain and ranks different QST according to their ability to reflect this effect. The results are expected to support the selection of QST for future studies on potential novel opioid agonists in human pain. METHODS In this randomized, placebo-controlled and double-blinded cross-over study, 50 patients with chronic low-back pain received a single oral dose of oxycodone 15mg or active placebo, and underwent multiple QST testing. The intensity of low-back pain was recorded during 2h. The areas under the ROC curves and 95% confidence intervals were determined, whereby responder status (≥30% pain reduction) was set as reference variable and changes in QST from baseline were set as classifiers. RESULTS Significant analgesic effect on low-back pain as well as anti-nociceptive effects for almost all QST parameters were observed. The QST with the highest area under the curve were heat pain detection threshold (0.65, 95%-CI 0.46 to 0.83), single-stimulus electrical pain threshold (0.64, 95%-CI 0.47 to 0.80) and pressure pain detection threshold (0.63, 95%-CI 0.48 to 0.79). CONCLUSIONS The results suggest that anti-nociceptive effects assessed by QST fairly reflect clinical efficacy of oxycodone on low-back pain. Pressure pain detection threshold, heat pain detection threshold and single-stimulus electrical pain threshold may be more suitable to sort out potential non-responders rather than identifying potential responders to opioid medication. Future pre-clinical human research may consider these results when investigating the analgesic effect of opioid agonists by means of QST.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Schliessbach, Jürg; Bütikofer, Lukas and Vuilleumier, Pascal Henri

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1877-8879

Publisher:

Elsevier

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

27 Sep 2017 16:05

Last Modified:

08 May 2018 09:38

Publisher DOI:

10.1016/j.sjpain.2017.07.004

PubMed ID:

28850362

Uncontrolled Keywords:

Analgesic effect Anti-nociceptive effect Chronic low-back pain Experimental pain Oxycodone Quantitative sensory tests

BORIS DOI:

10.7892/boris.105256

URI:

https://boris.unibe.ch/id/eprint/105256

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