January - April 1998

Anesta Corp. Announces First Prospective Clinical Study Of Breakthrough Pain Published In The Journal Of The National Cancer Institute (4/22/98)

Anesta Corp. announces clinical results from a prospective controlled study of Actiq (oral transmucosal fentanyl citrate or OTFC) have been published in the April issue of the Journal of the National Cancer Institute. The article, Oral Transmucosal Fentanyl Citrate: Randomized, Double- Blinded, Placebo-Controlled Trial for Treatment of Breakthrough Pain in Cancer Patients, is the first publication of a prospectively designed trial for the treatment of breakthrough pain in cancer patients. (Source: Anesta Corp. via PR Newswire)

Clonidine Patch Reduces Opioid Needs In Chronic Pain (4/21/98)

Use of transdermal clonidine reduced opioid intake in 100% of patients with severe intractable pain, with no loss of pain relief, Dr. Forest Tennant told the American Society of Addiction Medicine's 29th Annual Medical-Scientific Conference in New Orleans. Dr. Tennant, of the Research Center for Dependency Disorders and Chronic Pain in West Covina, California, pointed out that pseudoaddiction and dosage escalation occurs commonly among patients treated for chronic pain. Dr. Tennant studied 30 patients with severe intractable pain caused by trauma, "failed back" syndrome or neuromuscular diseases, whose daily morphine equivalence doses ranged from 50 to 100 mg. (Source: Reuters)

Transmucosal Fentanyl "Ideally Suited" For Cancer Breakthrough Pain (4/17/98)

Oral transmucosal fentanyl citrate is a promising option for the treatment of breakthrough pain in cancer patients. The finding comes from a study conducted by Dr. John T. Farrar of the University of Pennsylvania School of Medicine, in Philadelphia, and a multicenter team. The investigators examined the effects of the transmucosal fentanyl, in the form of a sweetened lozenge on a stick, in 92 cancer patients, aged 18 years or older. They were taking the equivalent of at least 60 mg/day oral morphine or 50 mcg/day transdermal fentanyl for chronic pain and experienced at least one episode of breakthrough pain per day. The researchers report their findings in the April 15 issue of the Journal of the National Cancer Institute. (Source: Reuters)

Diflunisal More Effective Than Dipyrone For Cancer Pain (4/14/98)

The nonsteroidal anti-inflammatory drugs diflunisal and dipyrone effectively relieve moderate to severe cancer pain and, at standard dosages, diflunisal is superior, Turkish researchers report. At Hacettepe University Institute of Oncology in Ankara, Dr. Suayib Yalcin and colleagues studied 47 patients with cancer, median age 52 years, who rated their pain severity as higher than 5 on a visual analog scale of 1 to 10. The researchers randomly assigned 24 patients to receive oral diflunisal, 500 mg twice daily, and 23 patients to receive oral dipyrone, 500 mg three times a day. The investigators report their findings in the American Journal of Clinical Oncology for April. (Source: Reuters)

Chronic Opioid Therapy Offers Benefits For Patients With Noncancer Pain (4/9/98)

Contrary to expectations, chronic opioid therapy for patients with noncancer pain does not decrease cognitive function. In fact, as reported by Dr. Jennifer A. Haythornthwaite and others at Johns Hopkins University in Baltimore, 19 patients receiving long-acting oral opioid therapy demonstrated stable cognitive abilities after an average of almost 6 months of treatment. The Johns Hopkins team compared a variety of outcomes in these 19 patients with outcomes in 10 patients with noncancer pain who were receiving usual care. Dr. Haythornthwaite and colleagues report their findings in the March issue of the Journal of Pain and Symptom Management. (Source: Reuters)

Women And Men Experience, Cope With Pain Differently (4/8/98)

Women have lower pain thresholds than men, but they also have more ways of coping, scientists said at a conference on gender differences in pain sponsored by the National Institutes of Health. One of the things women are doing is recognizing the problem earlier. So greater vulnerability brings greater strength. But women's increased sensitivity to pain and their ability to deal with it also has a downside, Dr. Berkley said. (Source: Reuters)

Preemptive Epidural Analgesia Significantly Reduces Postoperative Pain (4/8/98)

Preemptive epidural analgesia significantly reduces postoperative pain, even long-term after discharge. Dr. Allan Gottschalk and colleagues at the University of Pennsylvania randomized 100 "generally healthy" men who were scheduled to undergo radical prostatectomy to receive either epidural bupivacaine, epidural fentanyl, or no epidural drug, starting before induction of general anesthesia and continuing throughout the procedure. All patients received postoperative epidural anesthesia. The researchers analyzed patients' pain scores daily while they were hospitalized, as well as at 3.5, 5.5 and 9.5 weeks after discharge. The investigators published their findings in the April 8 issue of The Journal of the American Medical Association. (Source: Reuters)

Substance P Involved In Pain Perception And Suppression (3/27/98)

Experiments in mice indicate that the neuropeptide substance P may play a role in both perception of moderate to intense pain and the suppression of the pain response during periods of high stress, according to two studies in the March 26 issue of Nature. In one study, Dr. Yu Qing Cao of the University of California, and colleagues there and elsewhere compared the pain response of knockout mice deficient for the substance P-encoding gene, to that of wild-type mice. In the second study, UK and Spanish investigators led by Dr. Carmen De Felipe of Universidad Miguel Hernandez in Alicante, Spain, focused on the behaviors of knockout mice lacking substance P receptors. (Source: Reuters)

Newly Discovered Neuropeptide Blocks Pain Transmission (3/19/98)

The precursor for nociceptin, an endogenous neuropeptide that induces hyperalgesia and allodynia, has now been found to contain another peptide that blocks nociceptin's pain transmission activity. The newly discovered peptide has been termed nocistatin by the international team of researchers who describe it in Nature. Dr. Emiko Okuda-Ashitaka, of Kansai Medical University in Moriguchi, Japan, and others explain that nociceptin binds to an opioid-like receptor and induces the type of pain associated with chronic pain states, including hyperalgesia and allodynia, in which even innocuous tactile stimuli evoke pain. (Source: Reuters)

Morphine Suppositories An Option For Cancer Pain Control (2/26/98)

Controlled release morphine suppositories can be considered an alternative to tablets for patients with chronic severe cancer pain, Canadian researchers say. Dr. Dwight Moulin of Victoria Hospital, London, Ontario, and colleagues write in January's Journal of Clinical Pharmacology notes. The rectal route provides such an alternative, based on their randomized, double-blind, crossover study of 27 cancer patients given morphine tablets or suppositories every 12 hours for 7 days. Dr. Moulin's team says morphine suppositories should be considered in appropriate patients. (Source: Reuters)

Cytokines Overactive In Cases Of Neuropathic Pain (2/16/98)

Interleukin-6 appears to play a role in the generation of neuropathic pain, Dr. Joyce DeLeo of the University of Dartmouth School of Medicine told conferees at the annual meeting of the American Association for the Advancement of Science in Philadelphia. Interleukin-6, along with interleukin-1 and tumor necrosis factor-alpha, are expressed by glial cells in the spinal cord after injury. (Source: Reuters)

Americans Support Use Of High-Dose Pain Medications (1/29/98)

More than two-thirds of American adults say that they support use of high doses of pain medication such as morphine, according to a survey released at a health forum in Washington, DC. The survey of 1,000 Americans' attitudes toward pain was commissioned by the Mayday Fund, a New York City-based foundation. (Source: Reuters)

New Compound As Potent As Morphine Without Opioid Side Effects (1/2/98)

A newly developed compound controls pain as powerfully as morphine, but without the side effects of opioid analgesia. The new compound, which acts on neuronal nicotinic acetylcholine receptors, was developed by researchers at Abbott Laboratories in Abbott Park, Illinois, led by Dr. Anthony W. Bannon, along with colleagues at University College in London, UK. Dr. Bannon and his team report their findings in Science. (Source: Reuters)