buprenorphine and Mucositis

Chemotherapy-induced mucositis is an extremely painful condition that occurs in 40-60% of patients undergoing chemotherapy. As mucositis currently has no effective treatment, and due to the self-limiting nature of the condition, the major treatment aims are to manage symptoms and limit pain with significance placed on improving patient quality of life. Rodent models are frequently used in mucositis research. These investigations typically assess pathological outcomes, yet fail to include a measure of affective state; the key therapeutic goal. Assessment of cognitive biases is a novel approach to determining the affective state of animals. Consequently, this study aimed to validate a cognitive bias test through a judgement bias paradigm to measure affective state in a rat model of chemotherapy-induced intestinal mucositis. Rats with intestinal mucositis demonstrated a negative affective state, which was partially ameliorated by analgesic administration, whilst healthy rats showed an optimistic response. This study concluded that the judgement bias test was able to evaluate the emotional state of rats with chemotherapy-induced mucositis. These findings provide a foundation for future refinement to the experimental design associated with the animal model that will expedite successful transitioning of novel therapeutics to clinical practice, and also improve humane endpoint implementation.

Topics: Affect; Analgesics, Opioid; Animals; Antineoplastic Agents; Buprenorphine; Disease Models, Animal; Drug Evaluation, Preclinical; Fluorouracil; Intestinal Mucosa; Mucositis; Neoplasms; Quality of Life; Rats

Many head and neck cancer (HNC) patients experience painful therapy-related mucositis and dermatitis. This prospective observational study evaluated transdermal buprenorphine use in HNC patients to relieve treatment-related pain. During treatment with paracetamol or tramadol, visual analogue scale (VAS)-pain scores >30/100 occurred in 26/45 patients 4 weeks after starting cancer therapy, persisting for ≥2 weeks after treatment. These patients subsequently received transdermal buprenorphine. Pain therapy should be more accurately up-titrated to the maximum recommended dose (140 μg/hr) where necessary to maintain pain scores ≤30/100 and, for some patients, should be continued for 6 weeks after the last cancer treatment day.

Topics: Administration, Cutaneous; Aged; Analgesics, Opioid; Buprenorphine; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Mucositis; Pain; Pain Management; Pain Measurement; Prospective Studies; Radiation Injuries; Radiodermatitis

Topics: Administration, Cutaneous; Adult; Aged; Analgesics, Opioid; Buprenorphine; Female; Humans; Male; Middle Aged; Mouth Diseases; Mucositis; Pain Measurement; Pharyngeal Diseases; Stem Cell Transplantation; Young Adult