9
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Impact of Prophylactic Fentanyl Pectin Nasal Spray on Exercise-Induced Episodic Dyspnea in Cancer Patients: A Double-Blind, Randomized Controlled Trial

      , , , , ,
      Journal of Pain and Symptom Management
      Elsevier BV

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d5205797e140">Context</h5> <p id="P1">Episodic breathlessness is common and debilitating in cancer patients.</p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d5205797e145">Objectives</h5> <p id="P2">In this pilot study, we examined the effect of prophylactic fentanyl pectin nasal spray (FPNS) on exercise-induced dyspnea, physiologic function and adverse events. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d5205797e150">Methods</h5> <p id="P3">In this parallel, double-blind randomized placebo-controlled trial, opioid-tolerant patients performed three six-minute walk tests (6MWT) to induce dyspnea. They were randomized to receive either FPNS (15−25% of total daily opioid dose each time) or placebo 20 minutes before the second and third 6MWTs. We compared dyspnea numeric rating scale (NRS, 0−10, primary outcome), walk distance, vital signs, neurocognitive function and adverse events between the first and second 6MWTs (T2-T1) and between the first and third 6MWTs (T3-T1). </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d5205797e155">Results</h5> <p id="P4">Twenty-four patients enrolled, with 96% completion. FPNS was associated with significant within-arm reduction in dyspnea NRS at rest (T2-T1: −0.9 [95% confidence interval [CI] −1.7,−0.1]; T3-T1: −1.3 [95% CI −2.0,−0.5]) and after six minutes (T2-T1: −2.0 [95% CI −3.5,−0.6]; T3-T1: −2.3 [95% CI −4.0,−0.7]), and longer walk distance (T2-T1 +23.8m [95% CI +1.3,+46.2m]; T3-T1: +23.3m [95% CI −1.7,+48.2]). In the placebo arm, we observed no significant change in walk distance nor dyspnea NRS at rest, but significant reduction in dyspnea NRS at 6 minutes (T2-T1: −1.7 [95% CI −3.3,−0.1]; T3-T1: −2.5 [95% CI −4.2,−0.9]). Vital signs, neurocognitive function and adverse effects did not differ significantly. </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d5205797e160">Conclusion</h5> <p id="P5">FPNS was safe, reduced dyspnea at rest and increased walk distance in before-after comparison. The placebo effect was substantial, which needs to be factored in future study designs.( <a data-untrusted="" href="http://clinicaltrials.gov" id="d5205797e164" target="xrefwindow">clinicaltrials.gov</a> registration: NCT01832402) </p> </div>

          Related collections

          Author and article information

          Journal
          Journal of Pain and Symptom Management
          Journal of Pain and Symptom Management
          Elsevier BV
          08853924
          October 2016
          October 2016
          : 52
          : 4
          : 459-468.e1
          Article
          10.1016/j.jpainsymman.2016.05.013
          5075501
          27401508
          a8c046a4-50aa-49a1-8264-384499af0220
          © 2016

          http://www.elsevier.com/tdm/userlicense/1.0/

          History

          Comments

          Comment on this article