Pharmacoeconomic analysis of the application of strong opioids for the treatment of chronic pain syndrome in patients with pancreatic cancer

Objective: to evaluate the clinical and economic feasibility of opioid therapy based on the analysis of its cost and effectiveness in patients with chronic pain syndrome in pancreatic cancer.Material and methods. An observational prospective study in parallel groups of patients with chronic pain syndrome associated with pancreatic cancer was carried out. The analysis of cost minimization and cost-effectiveness was applied, as well as pharmacoeconomic modeling, which included the construction of a decision tree in patients receiving morphine sulfate (n=45) and fentanyl TTS (n=45) for pain relief. The sensitivity of the obtained data was assessed using one-way analysis.Results. It was shown that the treatment of chronic pain syndrome in patients with pancreatic cancer with opioid analgesics as part of combined treatment is the least expensive in the morphine sulfate group (incremental cost-effectiveness ratio 144.93). Based on the results of modeling, the prognostic factors of influence on the cost of analgesic therapy were determined: the cost of combined analgesic therapy, the cost of treatment of adverse reactions, and the cost-effectiveness ratio.Conclusion. Analgesic therapy of chronic pain syndrome with morphine sulfate in patients with pancreatic cancer is pharmacoeconomically feasible.

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Efficiency and safety of opioid therapy of chronic pain syndrome in patients with cancer of the refractory iron: clinico-pathogenetic features

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-170-10-45-51 ◽

2020 ◽

Vol 1 (10) ◽

pp. 45-51

Author(s):

O. P. Bobrova ◽

N. A. Schneider ◽

M. M. Petrova ◽

D. V. Dmitrenko ◽

S. K. Zyryanov ◽

...

Keyword(s):

Pancreatic Cancer ◽

Chronic Pain ◽

Clinical Features ◽

Pain Syndrome ◽

Opioid Therapy ◽

Chronic Pain Syndrome ◽

Efficacy And Safety ◽

Patients With Cancer ◽

Analgesic Therapy ◽

Comparison Groups

Aim. To study the influence of clinical and pathogenetic factors in patients with pancreatic cancer on the efficacy and safety of analgesic therapy of chronic pain syndrome.Materials and methods. Clinical features of formation of chronic pain syndrome predetermining the efficacy and safety of analgesic therapy were studied in 82 patients with pancreatic cancer.Results. The efficacy and safety of opioids in the comparison groups of morphine sulfate, fentanyl TTC and oxycodone / naloxone in patients with pancreatic cancer was shown.

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Treatment of chronic pain syndrome of patients with advanced forms of uterine cervical cancer in ambulatory conditions

Tumors of female reproductive system ◽

10.17650/1994-4098-2019-15-2-67-70 ◽

2019 ◽

Vol 15 (2) ◽

pp. 67-70

Author(s):

M. N. Burgoeva

Keyword(s):

Cervical Cancer ◽

Chronic Pain ◽

Severe Pain ◽

Pain Syndrome ◽

Uterine Cervical Cancer ◽

Morphine Sulfate ◽

Good Effect ◽

Chronic Pain Syndrome ◽

Effect Of Therapy ◽

Unbearable Pain

The analysis of the effectiveness of the use of morphine sulfate tablets in chronic pain syndrome in 52 patients with advanced cervical cancer (stage III–IV), which were under our supervision in 2015–2016, is presented. To assess the intensity of pain, was used a visual-analogue scale. All patients had pain syndrome: 39 (75 %) patients had severe pain (4–6 points), and 13 (25 %) had very severe unbearable pain (7–10 points). In all cases, with regular use of morphine sulfate tablets and ancillary drugs, a good effect of therapy was achieved: in 39 (75 %) patients the intensity of pain decreased from 4–6 points to 0–3 points, and in 13 (25 %) patients – from 7–10 points to 4–6 points.

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Clinical and economic feasibility study of the use of vitamin and mineral complexes in case of miscarriage

GYNECOLOGY ◽

10.26442/2079-5696_19.6.4-10 ◽

2017 ◽

Vol 19 (6) ◽

pp. 4-10

Author(s):

N A Kurmacheva ◽

E V Verizhnikova ◽

G Yu Chernyshova ◽

Yu V Chernenkov ◽

O M Kharitonova

Keyword(s):

Cost Effectiveness ◽

Pharmacoeconomic Analysis ◽

Economic Feasibility ◽

Fetal Hypoxia ◽

Cost Effectiveness Ratio ◽

High Doses ◽

Group B ◽

The Cost ◽

Folate Cycle ◽

Group B Vitamins

The purpose: to conduct a pharmacoeconomic analysis of two schemes of vitamin-mineral drugs in the peri-gestation period in women with habitual miscarriage and polymorphisms of folate cycle genes, giving birth to full-term children. Materials and methods: the cost-effectiveness of vitamin-mineral preparations in two groups of women was calculated. Patients of the 1st group (n=60) received pregravidno and during pregnancy a vitamin-mineral complex containing in one tablet metafolin, other vitamins of group B, vitamins C, E, PP and iodine (150 mcg) in physiological dosages, and also 200 mg of docosahexaenoic acid in a capsule intended for use from the 13th week until the end of pregnancy. Women of the 2nd group (n=54) took high doses of synthetic folic acid, vitamins B6 and B12 as part of two vitamin and mineral preparations during the pregravid preparation and gestational period. During pregnancy, the patients of both groups received an additional 100 mcg of potassium iodide daily. Results: in the 1st group, the cost-effectiveness ratio was 1.6 times lower and the clinical efficacy was significantly higher than in the 2nd group and consisted in a significant decrease in the incidence of preeclampsia, placental insufficiency, intrauterine fetal hypoxia, complications in the time of delivery, as well as the diseases in their children in the early neonatal period (1.5-3.9 times, p

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Chronic pain syndrome in patients with pancreatic cancer: individual therapy and its pathogenetic background

Russian Open Medical Journal ◽

10.15275/rusomj.2019.0205 ◽

2019 ◽

Vol 8 (2) ◽

pp. e0205

Author(s):

Olga P. Bobrova ◽

Natalia A. Shnayder ◽

Yuri A. Dykhno ◽

Sergei K. Zyryanov ◽

Marina M. Petrova

Keyword(s):

Pancreatic Cancer ◽

Chronic Pain ◽

Pain Syndrome ◽

Individual Therapy ◽

Chronic Pain Syndrome

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Predicting Opioid Therapy Safety In Pancreatic Cancer Patients

Russian Open Medical Journal ◽

10.15275/rusomj.2020.0417 ◽

2020 ◽

Vol 9 (4) ◽

Author(s):

Olga P. Bobrova ◽

Sergei K. Zyryanov ◽

Natalya A. Shnayder ◽

Marina M. Petrova

Keyword(s):

Risk Factors ◽

Pancreatic Cancer ◽

Chronic Pain ◽

Genetic Risk ◽

Pain Syndrome ◽

Opioid Therapy ◽

Chronic Pain Syndrome ◽

Drug Reactions ◽

Abcb1 Gene ◽

Comparison Groups

Background — Obligatory use of strong opioids for treating chronic pain syndrome in patients with pancreatic cancer provides the implementation of opioid-associated adverse reactions. Genetic and non-genetic risk factors are predictive of the opioid therapy safety. Contemporary methods of information analysis allow using prognostic risk models for practical application. Objective — Identification of significant risk factors for the development of opioid-associated adverse drug reactions in patients with chronic pain syndrome against the background of pancreatic cancer. Material and Methods — The study included 90 patients with chronic pain against the background of pancreatic cancer, randomized at a ratio of 1: 1. Group 1 received morphine sulfate (MS), group 2 received fentanyl transdermal therapeutic system (FTTS) with standard adjuvant therapy (ketoprofen, diazepam, amitriptyline). To assess pain level, the 10-point Digital Rating Scale, the Visual Analogue Scale and the pain questionnaires were used. The assessment of the treatment safety was conducted by the Naranjo Scale. Assessment of prognostic genetic and non-genetic factors was carried out using ROC analysis with calculation of AUC (the area under the ROC-curve). Results — Prognostic models of good quality were determined with the optimal ratio of sensitivity and specificity for the influence of genetic and non-genetic risk factors on the development of opioid-associated adverse drug reactions (OA-ADRs) in comparison groups. Various prognostic factors, complementing each other, were identified in the comparison groups. Conclusion — The following OA-ADRs predicting factors were identified: for FTTS-associated nausea and vomiting – age and carriage of rs7438135 AG genotype of UGT2B7 gene; for local reactions – the sum of points on the ESAS scale and carriage of rs7438135 AA genotype of UGT2B7 gene; for difficulty urinating – the level of glomerular filtration rate; for neurotoxicity – the level of AST and bilirubin, and the carriage of rs1128503 GG genotype of ABCB1 gene; for pruritus – carriage of rs1045642642 AA genotype of ABCB1 gene. The prognostic factors for the implementation of MS-associated neurotoxicity were age and comorbidity; for dry mouth was predicted best from the sum of points on the MMCE scale; weakness was predicted by the carriage of rs7668258 TT genotype of UGT2B7 gene.

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