ceruletide and Neoplasms

Caerulein (CRL) (5 micrograms i.m.) and morphine (10 mg i.m.) have been tested for their analgesic activity in a double blind randomized study in a total of 36 patients with medium to severe tumor pains. A decrease of more than 20 mm on a visual analogue scale (VAS) was taken as a criterion for successful therapy. This was the case in 67% of the patients treated with morphine and 50% of those treated with CRL. This difference is statistically not significant, but CRL has significantly fewer side-effects than morphine. The present data do not permit a definitive judgement on the value of CRL in the treatment of tumor pains. Further studies with more patients and different doses and administration routes are warranted.

Topics: Adult; Aged; Aged, 80 and over; Ceruletide; Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Morphine; Neoplasms; Pain; Pain Measurement; Random Allocation

Decapeptide ceruletide (CRL), chemically related to cholecystokinin and gastrin, proved to have remarkable analgesic properties when administered to a group of 22 burned patients, 15 patients with acute myocardial infarction, and 8 patients suffering from pain caused by malignant tumours with metastases. Its effect was such, that many of the patients required no other analgesics (opiates) even after a prolonged administration (up to 10 days) of CRL. In some of the patients a marked euphoria developed. There were no substantial changes in EEG records during CRL administration in 15 controls, among them 4 epileptics. It is probable that CRL helps to activate the internal analgesic system. In the burned patients cortisol, testosterone, renin, prolactin and tri-iodothyronine (T3) levels in serum (plasma) were measured (radio-immunoassays). CRL did not block the stress response (no drop of increased cortisol levels, no increase in low T3 levels), but it modified (influenced) it (drop of the high renin levels, and a tendency to increase the very low testosterone levels). CRL appears to act as an endorphin releaser, as evidenced by the plasma levels of beta-endorphins (quotations). CRL and similar drugs may represent a new, more physiological and probably safer approach to the management of pain.

Topics: beta-Endorphin; Burns; Ceruletide; Endorphins; Humans; Male; Myocardial Infarction; Neoplasm Metastasis; Neoplasms; Pain