Intrathecal Ziconotide for Neuropathic Pain: A Review.
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| Title: | Intrathecal Ziconotide for Neuropathic Pain: A Review. |
|---|---|
| Authors: | Rauck, Richard L., Wallace, Mark S., Burton, Allen W., Kapural, Leonardo, North, James M. |
| Source: | Pain Practice. Sep/Oct2009, Vol. 9 Issue 5, p327-337. 11p. 1 Diagram, 6 Charts. |
| Subjects: | Pain management, Joint diseases, Health outcome assessment, Etiology of diseases, Placebos |
| Abstract: | Neuropathic pain is a considerable burden that affects activities of daily living. The management of neuropathic pain can be challenging because of multiple etiologies and complex manifestations. Ziconotide is a nonopioid intrathecal (IT) analgesic option for patients with neuropathic pain refractory to conventional treatments. The objective of this article is to review the published literature on ziconotide for the treatment of neuropathic pain. Relevant publications were identified through searches of all years of 6 databases, which included PubMed, EMBASE, and CINAHL. Search terms used were ziconotide, SNX-111, MVIIA, Prialt, and neuropathic pain. Publications were included if ziconotide was intrathecally administered (either alone or in combination with other IT agents) to treat neuropathic pain of any etiology and if pain assessment was an outcome measure. Data extracted included study design, IT drug doses, pain outcome measures, and adverse events (AEs). Twenty-eight articles met the inclusion criteria: 5 were preclinical studies and 23 were clinical studies. In the preclinical studies, ziconotide demonstrated antiallodynic effects on neuropathic pain. Data from double-blind, placebo-controlled (DBPC) trials indicated that patients with neuropathic pain reported a mean percent improvement in pain score with ziconotide monotherapy that ranged from 15.7% to 31.6%. A low starting dose and slow titration of ziconotide resulted in an improved safety profile in the aforementioned trials. Common AEs associated with ziconotide include nausea and/or vomiting, dizziness, confusion, urinary retention, and somnolence. Evidence from DBPC trials, open-label studies, case series, and case studies suggests that ziconotide, as either monotherapy or in combination with other IT drugs, is a potential therapeutic option for patients with refractory neuropathic pain. Additional studies are needed to establish the long-term efficacy and safety of ziconotide for neuropathic pain. [ABSTRACT FROM AUTHOR] |
| Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 44016366 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Intrathecal Ziconotide for Neuropathic Pain: A Review. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Rauck%2C+Richard+L%2E%22">Rauck, Richard L.</searchLink><br /><searchLink fieldCode="AR" term="%22Wallace%2C+Mark+S%2E%22">Wallace, Mark S.</searchLink><br /><searchLink fieldCode="AR" term="%22Burton%2C+Allen+W%2E%22">Burton, Allen W.</searchLink><br /><searchLink fieldCode="AR" term="%22Kapural%2C+Leonardo%22">Kapural, Leonardo</searchLink><br /><searchLink fieldCode="AR" term="%22North%2C+James+M%2E%22">North, James M.</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pain+Practice%22">Pain Practice</searchLink>. Sep/Oct2009, Vol. 9 Issue 5, p327-337. 11p. 1 Diagram, 6 Charts. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Pain+management%22">Pain management</searchLink><br /><searchLink fieldCode="DE" term="%22Joint+diseases%22">Joint diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Etiology+of+diseases%22">Etiology of diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Placebos%22">Placebos</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Neuropathic pain is a considerable burden that affects activities of daily living. The management of neuropathic pain can be challenging because of multiple etiologies and complex manifestations. Ziconotide is a nonopioid intrathecal (IT) analgesic option for patients with neuropathic pain refractory to conventional treatments. The objective of this article is to review the published literature on ziconotide for the treatment of neuropathic pain. Relevant publications were identified through searches of all years of 6 databases, which included PubMed, EMBASE, and CINAHL. Search terms used were ziconotide, SNX-111, MVIIA, Prialt, and neuropathic pain. Publications were included if ziconotide was intrathecally administered (either alone or in combination with other IT agents) to treat neuropathic pain of any etiology and if pain assessment was an outcome measure. Data extracted included study design, IT drug doses, pain outcome measures, and adverse events (AEs). Twenty-eight articles met the inclusion criteria: 5 were preclinical studies and 23 were clinical studies. In the preclinical studies, ziconotide demonstrated antiallodynic effects on neuropathic pain. Data from double-blind, placebo-controlled (DBPC) trials indicated that patients with neuropathic pain reported a mean percent improvement in pain score with ziconotide monotherapy that ranged from 15.7% to 31.6%. A low starting dose and slow titration of ziconotide resulted in an improved safety profile in the aforementioned trials. Common AEs associated with ziconotide include nausea and/or vomiting, dizziness, confusion, urinary retention, and somnolence. Evidence from DBPC trials, open-label studies, case series, and case studies suggests that ziconotide, as either monotherapy or in combination with other IT drugs, is a potential therapeutic option for patients with refractory neuropathic pain. Additional studies are needed to establish the long-term efficacy and safety of ziconotide for neuropathic pain. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/j.1533-2500.2009.00303.x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 327 Subjects: – SubjectFull: Pain management Type: general – SubjectFull: Joint diseases Type: general – SubjectFull: Health outcome assessment Type: general – SubjectFull: Etiology of diseases Type: general – SubjectFull: Placebos Type: general Titles: – TitleFull: Intrathecal Ziconotide for Neuropathic Pain: A Review. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Rauck, Richard L. – PersonEntity: Name: NameFull: Wallace, Mark S. – PersonEntity: Name: NameFull: Burton, Allen W. – PersonEntity: Name: NameFull: Kapural, Leonardo – PersonEntity: Name: NameFull: North, James M. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: Sep/Oct2009 Type: published Y: 2009 Identifiers: – Type: issn-print Value: 15307085 Numbering: – Type: volume Value: 9 – Type: issue Value: 5 Titles: – TitleFull: Pain Practice Type: main |
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