在帕金森病诊断之前和之后阿片类药物使用的发生率
Majd Al-Sagheer1, Niina Karttunen1, Anne Paakinaho1
1School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
European journal of pain (London, England)
|June 9, 2025
概括
即使在诊断之前,阿片类药物的使用也在帕金森病 (PD) 患者中显著增加,这表明早期疼痛. 这种趋势在诊断后继续,随着时间的推移,人们开始转向更强大的止痛药.
科学领域:
- 神经学 神经学
- 疼痛管理 疼痛管理
- 流行病学 流行病学
背景情况:
- 疼痛是帕金森病 (PD) 的普遍症状和前兆标志.
- 在PD患者中使用止痛药的不断变化的模式,特别是阿片类药物,仍未得到充分描述.
- 这项研究调查了与PD诊断相对的阿片类药物使用率的变化.
研究的目的:
- 为了检查帕金森病 (PD) 患者在诊断前和诊断后五年内阿片类药物启动的发生率.
- 为了比较PD患者和没有PD的匹配队列之间的阿片类药物使用模式.
- 为了确定与PD诊断有关的不同类别的止痛药在阿片类药物使用中的时间趋势.
主要方法:
- 利用芬兰全国性基于帕金森病的登记册研究 (FINPARK).
- 包括15,763名被诊断患有事件PD的个人和62,907名匹配的对照.
- 计算了6个月间隔的阿片类药物开始率,并使用发病率比率 (IRR) 分析了差异.
主要成果:
- 在PD患者中,阿片类药物启动的频率比对照组 (31.2%) 高 (37.0%).
- 在PD诊断前三年,阿片类药物使用增加显而易见 (IRR1.33),并在整个随访期间持续存在.
- 轻度阿片类药物,如特拉马多尔和可代因,在诊断前六个月显示出最大的差异,而强度阿片类药物在诊断后增加.
结论:
- 研究结果强调了PD中存在中度至严重的疼痛,需要服用阿片类止痛药.
- 在PD的前运动或早期运动阶段,在确诊诊断之前,阿片类药物启动率较高.
- 随着帕金森病的进展,人们观察到向更强大的阿片类药物的进展,这表明需要优化疼痛管理策略.
相关概念视频
01:24Parkinson's Disease: Treatment
233
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
233
01:15Parkinson's Disease: Overview
492
Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
492
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
239
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
239
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
190
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
190
01:25Analgesia and Pain Management
547
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
547
01:22Opioid Receptors: Overview
564
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
564