Methadone in post-herpetic neuralgia: A pilot proof-of-concept study
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/76938 |
Resumo: | OBJECTIVE: This research was designed as a pilot proof-of-concept study to evaluate the use of low-dose methadone in post-herpetic neuralgia patients who remained refractory after first and second line post-herpetic neuralgia treatments and had indications for adding an opioid agent to their current drug regimens. METHODS: This cross-over study was double blind and placebo controlled. Ten opioid naïve post-herpetic neuralgia patients received either methadone (5 mg bid) or placebo for three weeks, followed by a 15-day washout period and a second three-week treatment with either methadone or placebo, accordingly. Clinical evaluations were performed four times (before and after each three-week treatment period). The evaluations included the visual analogue scale, verbal category scale, daily activities scale, McGill pain questionnaire, adverse events profile, and evoked pain assessment. All patients provided written informed consent before being included in the study. ClinicalTrials.gov: NCT01752699 RESULTS: Methadone, when compared to placebo, did not significantly affect the intensity of spontaneous pain, as measured by the visual analogue scale. The intensity of spontaneous pain was significantly decreased after the methadone treatment compared to placebo on the category verbal scale (50% improved after the methadone treatment, none after the placebo, p = 0.031). Evoked pain was reduced under methadone compared to placebo (50% improved after the methadone treatment, none after the placebo, p = 0.031). Allodynia reduction correlated with sleep improvement (r = 0.67, p = 0.030) during the methadone treatment. The side effects profile was similar between both treatments. Conclusions: Methadone seems to be safe and efficacious in post-herpetic neuralgia. It should be tried as an adjunctive treatment for post-herpetic neuralgia in larger prospective studies. |
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oai:revistas.usp.br:article/76938 |
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Clinics |
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Methadone in post-herpetic neuralgia: A pilot proof-of-concept studyOBJECTIVE: This research was designed as a pilot proof-of-concept study to evaluate the use of low-dose methadone in post-herpetic neuralgia patients who remained refractory after first and second line post-herpetic neuralgia treatments and had indications for adding an opioid agent to their current drug regimens. METHODS: This cross-over study was double blind and placebo controlled. Ten opioid naïve post-herpetic neuralgia patients received either methadone (5 mg bid) or placebo for three weeks, followed by a 15-day washout period and a second three-week treatment with either methadone or placebo, accordingly. Clinical evaluations were performed four times (before and after each three-week treatment period). The evaluations included the visual analogue scale, verbal category scale, daily activities scale, McGill pain questionnaire, adverse events profile, and evoked pain assessment. All patients provided written informed consent before being included in the study. ClinicalTrials.gov: NCT01752699 RESULTS: Methadone, when compared to placebo, did not significantly affect the intensity of spontaneous pain, as measured by the visual analogue scale. The intensity of spontaneous pain was significantly decreased after the methadone treatment compared to placebo on the category verbal scale (50% improved after the methadone treatment, none after the placebo, p = 0.031). Evoked pain was reduced under methadone compared to placebo (50% improved after the methadone treatment, none after the placebo, p = 0.031). Allodynia reduction correlated with sleep improvement (r = 0.67, p = 0.030) during the methadone treatment. The side effects profile was similar between both treatments. Conclusions: Methadone seems to be safe and efficacious in post-herpetic neuralgia. It should be tried as an adjunctive treatment for post-herpetic neuralgia in larger prospective studies.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2013-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/7693810.1590/clin.v68i7.76938Clinics; Vol. 68 No. 7 (2013); 1057-1060Clinics; v. 68 n. 7 (2013); 1057-1060Clinics; Vol. 68 Núm. 7 (2013); 1057-10601980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/76938/80799Teixeira, Manoel J.Okada, MassakoMoscoso, Ana Sofia CuevaPuerta, Mariana Yumi TakahashiYeng, Lin T.Galhardoni, RicardoTengan, Sergiode Andrade, Daniel Ciampiinfo:eu-repo/semantics/openAccess2014-03-24T11:50:37Zoai:revistas.usp.br:article/76938Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2014-03-24T11:50:37Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study |
title |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study |
spellingShingle |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study Teixeira, Manoel J. |
title_short |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study |
title_full |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study |
title_fullStr |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study |
title_full_unstemmed |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study |
title_sort |
Methadone in post-herpetic neuralgia: A pilot proof-of-concept study |
author |
Teixeira, Manoel J. |
author_facet |
Teixeira, Manoel J. Okada, Massako Moscoso, Ana Sofia Cueva Puerta, Mariana Yumi Takahashi Yeng, Lin T. Galhardoni, Ricardo Tengan, Sergio de Andrade, Daniel Ciampi |
author_role |
author |
author2 |
Okada, Massako Moscoso, Ana Sofia Cueva Puerta, Mariana Yumi Takahashi Yeng, Lin T. Galhardoni, Ricardo Tengan, Sergio de Andrade, Daniel Ciampi |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Teixeira, Manoel J. Okada, Massako Moscoso, Ana Sofia Cueva Puerta, Mariana Yumi Takahashi Yeng, Lin T. Galhardoni, Ricardo Tengan, Sergio de Andrade, Daniel Ciampi |
description |
OBJECTIVE: This research was designed as a pilot proof-of-concept study to evaluate the use of low-dose methadone in post-herpetic neuralgia patients who remained refractory after first and second line post-herpetic neuralgia treatments and had indications for adding an opioid agent to their current drug regimens. METHODS: This cross-over study was double blind and placebo controlled. Ten opioid naïve post-herpetic neuralgia patients received either methadone (5 mg bid) or placebo for three weeks, followed by a 15-day washout period and a second three-week treatment with either methadone or placebo, accordingly. Clinical evaluations were performed four times (before and after each three-week treatment period). The evaluations included the visual analogue scale, verbal category scale, daily activities scale, McGill pain questionnaire, adverse events profile, and evoked pain assessment. All patients provided written informed consent before being included in the study. ClinicalTrials.gov: NCT01752699 RESULTS: Methadone, when compared to placebo, did not significantly affect the intensity of spontaneous pain, as measured by the visual analogue scale. The intensity of spontaneous pain was significantly decreased after the methadone treatment compared to placebo on the category verbal scale (50% improved after the methadone treatment, none after the placebo, p = 0.031). Evoked pain was reduced under methadone compared to placebo (50% improved after the methadone treatment, none after the placebo, p = 0.031). Allodynia reduction correlated with sleep improvement (r = 0.67, p = 0.030) during the methadone treatment. The side effects profile was similar between both treatments. Conclusions: Methadone seems to be safe and efficacious in post-herpetic neuralgia. It should be tried as an adjunctive treatment for post-herpetic neuralgia in larger prospective studies. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-07-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/76938 10.1590/clin.v68i7.76938 |
url |
https://www.revistas.usp.br/clinics/article/view/76938 |
identifier_str_mv |
10.1590/clin.v68i7.76938 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/76938/80799 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 68 No. 7 (2013); 1057-1060 Clinics; v. 68 n. 7 (2013); 1057-1060 Clinics; Vol. 68 Núm. 7 (2013); 1057-1060 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222760278949888 |