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Editorial

Therapeutics and Clinical Risk Management

Dove Medical Press

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      Tramadol extended-release in the management of chronic pain

      Chronic, noncancer pain such as that associated with osteoarthritis of the hip and knee is typically managed according to American College of Rheumatology guidelines. Patients unresponsive to first-line treatment with acetaminophen receive nonsteroidal antiinflammatory drugs (NSAIDs), including cyclooxygenase-2 (COX-2) inhibitors. However, many patients may have chronic pain that is refractory to these agents, or they may be at risk for the gastrointestinal, renal, and cardiovascular complications associated with their use. Tramadol, a mild opioid agonist and norepinephrine and serotonin reuptake inhibitor, is recommended by current guidelines for the treatment of moderate to moderately severe pain in patients who have not responded to previous oral therapy, or in patients who have contraindications to COX-2 inhibitors and nonselective NSAIDs. An extended-release (ER) formulation of tramadol was approved by the US Food and Drug Administration in September 2005. In contrast with immediate-release (IR) tramadol, this ER formulation allows once-daily dosing, providing around-the-clock analgesia. In clinical studies, tramadol ER has demonstrated a lower incidence of adverse events than that reported for IR tramadol. Unlike nonselective NSAIDs and COX-2 inhibitors, tramadol ER is not associated with gastrointestinal, renal, or cardiovascular complications. Although tramadol is an opioid agonist, significant abuse has not been demonstrated after long-term therapy. It is concluded that tramadol ER has an efficacy and safety profile that warrants its early use for the management of chronic pain, either alone or in conjunction with nonselective NSAIDs and COX-2 inhibitors.
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        The safety and efficacy of alefacept in the treatment of chronic plaque psoriasis

         C. Jenneck,  N Novak (2007)
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          Current aproach to cancer pain management: availability and implications of different treatment options

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            Author and article information

            Affiliations
            simpleAsthmatic and Allergy Inflammation Group, School of Medicine, University of Aberdeen UK
            Journal
            Ther Clin Risk Manag
            Therapeutics and Clinical Risk Management
            Therapeutics and Clinical Risk Management
            Dove Medical Press
            1176-6336
            1178-203X
            June 2007
            June 2007
            : 3
            : 3
            : 361-362
            2386349
            18488067
            © 2007 Dove Medical Press Limited. All rights reserved
            Categories
            Editorial Foreword

            Medicine

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