| Title |
Postoperative opioid sparing with injectable hydroxypropyl-β-cyclodextrin-diclofenac: pooled analysis of data from two Phase III clinical trials
|
|---|---|
| Published in |
Journal of Pain Research, December 2016
|
| DOI | 10.2147/jpr.s106578 |
| Pubmed ID | |
| Authors |
Tong J Gan, Neil Singla, Stephen E Daniels, Douglas A Hamilton, Peter G Lacouture, Christian RD Reyes, Daniel B Carr |
| Abstract |
Use of nonopioid analgesics (including nonsteroidal anti-inflammatory drugs) for postoperative pain management can reduce opioid consumption and potentially prevent opioid-related adverse events. This study examined the postoperative opioid-sparing effect of repeated-dose injectable diclofenac formulated with hydroxypropyl-β-cyclodextrin (HPβCD)-diclofenac. Pooled data from two double-blind, randomized, placebo- and active comparator-controlled Phase III trials were analyzed. Patients received HPβCD-diclofenac, placebo, or ketorolac by intravenous injection every 6 hours for up to 5 days following abdominal/pelvic or orthopedic surgery. Rescue opioid use was evaluated from the time of first study drug administration to up to 120 hours following the first dose in the overall study population and in subgroups defined by baseline pain severity, age, and HPβCD-diclofenac dose. Overall, 608 patients received ≥1 dose of study medication and were included in the analysis. While 93.2% of patients receiving placebo required opioids, the proportion of patients requiring opioids was significantly lower for patients receiving HPβCD-diclofenac (18.75, 37.5, or 50 mg) or ketorolac (P<0.005 for all comparisons). Mean cumulative opioid dose and number of doses were significantly lower among patients receiving HPβCD-diclofenac versus placebo for the 0-24 through 0-120 hour time periods (P<0.0001), as well as versus ketorolac for the 0-72 through 0-120 hour time periods (P<0.05). HPβCD-diclofenac significantly reduced opioid consumption versus placebo in subgroups based on baseline pain severity (moderate, severe) and age (<65 years, ≥65 years) from the 0-24 hour period onward. When compared to ketorolac, HPβCD-diclofenac also significantly reduced cumulative opioid consumption among patients with moderate baseline pain (0-72 through 0-120 hours) and opioid dose number among patients ≥65 years old (0-24 through 0-120 hours). HPβCD-diclofenac can reduce postoperative opioid requirements. As this analysis was not powered to compare opioid-related adverse event rates, follow-up studies examining the clinical impact of HPβCD-diclofenac's opioid sparing are warranted. |
Mendeley readers
The data shown below were compiled from readership statistics for 28 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | 4% |
| Unknown | 27 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 6 | 21% |
| Student > Bachelor | 5 | 18% |
| Other | 3 | 11% |
| Researcher | 3 | 11% |
| Student > Postgraduate | 2 | 7% |
| Other | 5 | 18% |
| Unknown | 4 | 14% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 54% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 7% |
| Nursing and Health Professions | 2 | 7% |
| Agricultural and Biological Sciences | 2 | 7% |
| Psychology | 1 | 4% |
| Other | 1 | 4% |
| Unknown | 5 | 18% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 August 2020.
All research outputs
#8,880,246
of 25,998,826 outputs
Outputs from Journal of Pain Research
#886
of 2,009 outputs
Outputs of similar age
#147,178
of 423,051 outputs
Outputs of similar age from Journal of Pain Research
#22
of 51 outputs
Altmetric has tracked 25,998,826 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,009 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.2. This one has gotten more attention than average, scoring higher than 52% of its peers.
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We're also able to compare this research output to 51 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.