类阿片类止痛药用于类风湿性关节炎疼痛
Samuel L Whittle1, Bethan L Richards, Rachelle Buchbinder
1Rheumatology Unit, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville S, South Australia 5011, Australia. sam@whit.tl
JAMA
|February 7, 2013
概括
较弱的阿片类药物可能会为类风湿性关节炎的疼痛提供短期缓解,但常见的副作用往往超过益处. 对于持续的类风湿性关节炎不适,建议采用替代疼痛管理策略.
科学领域:
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,导致持续的关节疼痛和炎症.
- 有效的疼痛管理对于维持RA患者的生活质量至关重要.
- 有时考虑使用阿片类止痛药来治疗慢性疼痛.
研究的目的:
- 评估弱阿片类止痛药在类风湿性关节炎中持续疼痛的风险-益处概况.
- 确定弱阿片类药物的益处是否超过它们在RA患者的潜在不良影响.
主要方法:
- 临床试验和观察性研究的系统审查.
- 对短期缓解疼痛的疗效数据的分析.
- 评估与弱度阿片类药物使用相关的报告不良事件.
主要成果:
- 较弱的阿片类药物 (例如,可代因,特拉马多尔) 在治疗类风湿性关节炎疼痛方面表现出短期的有效性.
- 经常报告副作用,包括恶心,头和便秘.
- 副作用的发生率和严重程度可能会对某些患者的治疗效益造成负面影响.
结论:
- 在持续性类风湿性关节炎疼痛中使用弱性阿片类药物存在重大风险-益处挑战.
- 由于常见的不良影响,替代止痛药应该优先考虑弱阿片类药物.
- 对类风湿性关节炎更安全,更长期的疼痛管理选择进行进一步的研究是有必要的.
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