Effectiveness and Safety of Oxycodone/naloxone in the Management of Chronic Pain in Patients with Systemic Sclerosis with Recurrent Digital Ulcers: Two Case Reports

Overview

Journal Clin Interv Aging

Publisher Dove Medical Press

Specialty Geriatrics

Date 2016 Apr 5

PMID 27042030

Citations 4

Authors

Nicola Ughi

Chiara Crotti

Francesca Ingegnoli

Affiliations

Soon will be listed here.

Abstract

Digital ulcers (DUs) are a severe and frequent clinical feature of patients with systemic sclerosis (SSc). The presence of DUs may cause severe pain and often lead to impairment of patient's functional activities and health-related quality of life. Moreover, poor patient cooperation during the wound care procedure due to pain may be associated with a negative outcome of DU healing. Therefore, pain management has a key role in patients with SSc. These two case reports describe the effectiveness and safety of oxycodone/naloxone in patients with SSc complicated by painful chronic DUs. Such a therapy has provided pain relief and consequently an increased compliance during redressing wounds.

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References

Mouthon L, Mestre-Stanislas C, Berezne A, Rannou F, Guilpain P, Revel M . Impact of digital ulcers on disability and health-related quality of life in systemic sclerosis. Ann Rheum Dis. 2009; 69(1):214-7. DOI: 10.1136/ard.2008.094193. View

Khanna D, Hays R, Maranian P, Seibold J, Impens A, Mayes M . Reliability and validity of the University of California, Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument. Arthritis Rheum. 2009; 61(9):1257-63. PMC: 2767193. DOI: 10.1002/art.24730. View

Berezne A, Seror R, Morell-Dubois S, de Menthon M, Fois E, Dzeing-Ella A . Impact of systemic sclerosis on occupational and professional activity with attention to patients with digital ulcers. Arthritis Care Res (Hoboken). 2010; 63(2):277-85. DOI: 10.1002/acr.20342. View

Ennis H, Vail A, Wragg E, Taylor A, Moore T, Murray A . A prospective study of systemic sclerosis-related digital ulcers: prevalence, location, and functional impact. Scand J Rheumatol. 2013; 42(6):483-6. DOI: 10.3109/03009742.2013.780095. View

Mouthon L, Carpentier P, Lok C, Clerson P, Gressin V, Hachulla E . Ischemic digital ulcers affect hand disability and pain in systemic sclerosis. J Rheumatol. 2014; 41(7):1317-23. DOI: 10.3899/jrheum.130900. View

Giuggioli D, Manfredi A, Vacchi C, Sebastiani M, Spinella A, Ferri C . Procedural pain management in the treatment of scleroderma digital ulcers. Clin Exp Rheumatol. 2014; 33(1):5-10. View

Poelaert J, Koopmans-Klein G, Dioh A, Louis F, Gorissen M, Loge D . Treatment with prolonged-release oxycodone/naloxone improves pain relief and opioid-induced constipation compared with prolonged-release oxycodone in patients with chronic severe pain and laxative-refractory constipation. Clin Ther. 2015; 37(4):784-92. DOI: 10.1016/j.clinthera.2015.02.010. View

Stern E, Denton C . The Pathogenesis of Systemic Sclerosis. Rheum Dis Clin North Am. 2015; 41(3):367-82. DOI: 10.1016/j.rdc.2015.04.002. View

Di Franco M, Bazzichi L, Casale R, Sarzi-Puttini P, Atzeni F . Pain in systemic connective tissue diseases. Best Pract Res Clin Rheumatol. 2015; 29(1):53-62. DOI: 10.1016/j.berh.2015.05.006. View

10.

Guerriero F, Maurizi N, Francis M, Sgarlata C, Ricevuti G, Rondanelli M . Is oxycodone/naloxone effective and safe in managing chronic pain of a fragile elderly patient with multiple skin ulcers of the lower limbs? A case report. Clin Interv Aging. 2015; 10:1283-7. PMC: 4536765. DOI: 10.2147/CIA.S84711. View

11.

Brand M, Hollaender R, Rosenberg D, Scott M, Hunsche E, Tyndall A . An observational cohort study of patients with newly diagnosed digital ulcer disease secondary to systemic sclerosis registered in the EUSTAR database. Clin Exp Rheumatol. 2015; 33(4 Suppl 91):S47-54. View

12.

Gualtierotti R, Ingegnoli F, Two R, Meroni P, Khanna D, Adorni G . Reliability and validity of the Italian version of the UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument in patients with systemic sclerosis. Clin Exp Rheumatol. 2015; 33(4 Suppl 91):S55-60. View

13.

Valenzuela A, Chung L . Calcinosis: pathophysiology and management. Curr Opin Rheumatol. 2015; 27(6):542-8. DOI: 10.1097/BOR.0000000000000220. View

14.

Mihai C, Landewe R, van der Heijde D, Walker U, Constantin P, Gherghe A . Digital ulcers predict a worse disease course in patients with systemic sclerosis. Ann Rheum Dis. 2015; 75(4):681-6. DOI: 10.1136/annrheumdis-2014-205897. View

15.

Bonezzi C, Nava A, Barbieri M, Bettaglio R, Demartini L, Miotti D . [Validazione della versione italiana del Brief Pain Inventory nei pazienti con dolore cronico]. Minerva Anestesiol. 2002; 68(7-8):607-11. View

16.

Merkel P, Herlyn K, Martin R, Anderson J, Mayes M, Bell P . Measuring disease activity and functional status in patients with scleroderma and Raynaud's phenomenon. Arthritis Rheum. 2002; 46(9):2410-20. DOI: 10.1002/art.10486. View

17.

Guseva N, Alekperov R, Anikina N . [Tramadol in the vascular pains of patients with systemic scleroderma and other rheumatic diseases]. Ter Arkh. 1994; 66(1):20-4. View

18.

Hachulla E, Clerson P, Launay D, Lambert M, Morell-Dubois S, Queyrel V . Natural history of ischemic digital ulcers in systemic sclerosis: single-center retrospective longitudinal study. J Rheumatol. 2007; 34(12):2423-30. View

19.

van Ingen I, Jansen M, Barrera P . Topical opioids for painful ulcers in systemic sclerosis. Ann Rheum Dis. 2008; 67(3):427. DOI: 10.1136/ard.2007.076224. View

20.

Chou R, Fanciullo G, Fine P, Adler J, Ballantyne J, Davies P . Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009; 10(2):113-30. PMC: 4043401. DOI: 10.1016/j.jpain.2008.10.008. View