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Open Access 01-03-2016 | Original Article

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

Authors: Roger von Moos, Jean-Jacques Body, Blair Egerdie, Alison Stopeck, Janet Brown, Lesley Fallowfield, Donald L. Patrick, Charles Cleeland, Danail Damyanov, Felipe Salvador Palazzo, Gavin Marx, Ying Zhou, Ada Braun, Arun Balakumaran, Yi Qian

Published in: Supportive Care in Cancer | Issue 3/2016

Abstract

Purpose

Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients’ pain, analgesic use, and pain interference with daily functioning.

Methods

Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm.

Results

The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function.

Conclusions

SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning.

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Title: Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases
Authors: Roger von Moos
Jean-Jacques Body
Blair Egerdie
Alison Stopeck
Janet Brown
Lesley Fallowfield
Donald L. Patrick
Charles Cleeland
Danail Damyanov
Felipe Salvador Palazzo
Gavin Marx
Ying Zhou
Ada Braun
Arun Balakumaran
Yi Qian
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 3/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2908-1

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