Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences

More than half of patients with opioid use disorder for chronic non-cancer pain (CNCP) reduced their dose through a progressive opioid withdrawal supported by a rotation to buprenorphine and/or tramadol. The aim of this research is to analyse the long-term effectiveness of opioid deprescription taki...

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Autores: Muriel, J, Escorial, M, Margarit, C, Barrachina, J, Carvajal, C, Morales, D, Peiro, AM
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p9702
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones9702
https://acta.pharmaceutica.farmaceut.org/publications/2023-issue-1-acta-pharm-vol-73-2/
Access Level:acceso abierto
Palabra clave:chronic pain
drug deprescription
opioid use disorder
long-term monitoring
pharmacogenetics
sex differences
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spelling Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differencesMuriel, JEscorial, MMargarit, CBarrachina, JCarvajal, CMorales, DPeiro, AMchronic paindrug deprescriptionopioid use disorderlong-term monitoringpharmacogeneticssex differencesMore than half of patients with opioid use disorder for chronic non-cancer pain (CNCP) reduced their dose through a progressive opioid withdrawal supported by a rotation to buprenorphine and/or tramadol. The aim of this research is to analyse the long-term effectiveness of opioid deprescription taking into account the impact of sex and pharmacogenetics on the inter-individual variability. A cross-sectional study was carried out from October 2019 to June 2020 on CNCP patients who had previously undergone an opioid deprescription (n = 119 patients). Demographic, clinical (pain, relief and adverse events) and therapeutic (analgesic use) outcomes were collected. Effectiveness (< 50 mg per day of morphine equivalent daily dose without any aberrant opioid use behaviour) and safety (number of side-effects) were analysed in relation to sex differences and pharmacogenetic markers impact [OPRM1 genotype (rs1799971) and CYP2D6 phenotypes]. Long-term opioid deprescription was achieved in 49 % of the patients with an increase in pain relief and a reduction of adverse events. CYP2D6 poor metabolizers showed the lowest long-term opioid doses. Here, women showed a higher degree of opioid deprescription, but increased use of tramadol and neuromodulators, as well as an increased number of adverse events. Long-term deprescription was successful in half of the cases. Understanding sex and gender interaction plus a genetic impact could help to design more individualized strategies for opioid deprescription.SCIENDO2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones9702https://acta.pharmaceutica.farmaceut.org/publications/2023-issue-1-acta-pharm-vol-73-2/ACTA PHARMACEUTICAISSN: 13300075ISSNe: 18469558reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p97022026-06-12T10:20:37Z
dc.title.none.fl_str_mv Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
title Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
spellingShingle Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
Muriel, J
chronic pain
drug deprescription
opioid use disorder
long-term monitoring
pharmacogenetics
sex differences
title_short Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
title_full Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
title_fullStr Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
title_full_unstemmed Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
title_sort Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences
dc.creator.none.fl_str_mv Muriel, J
Escorial, M
Margarit, C
Barrachina, J
Carvajal, C
Morales, D
Peiro, AM
author Muriel, J
author_facet Muriel, J
Escorial, M
Margarit, C
Barrachina, J
Carvajal, C
Morales, D
Peiro, AM
author_role author
author2 Escorial, M
Margarit, C
Barrachina, J
Carvajal, C
Morales, D
Peiro, AM
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv chronic pain
drug deprescription
opioid use disorder
long-term monitoring
pharmacogenetics
sex differences
topic chronic pain
drug deprescription
opioid use disorder
long-term monitoring
pharmacogenetics
sex differences
description More than half of patients with opioid use disorder for chronic non-cancer pain (CNCP) reduced their dose through a progressive opioid withdrawal supported by a rotation to buprenorphine and/or tramadol. The aim of this research is to analyse the long-term effectiveness of opioid deprescription taking into account the impact of sex and pharmacogenetics on the inter-individual variability. A cross-sectional study was carried out from October 2019 to June 2020 on CNCP patients who had previously undergone an opioid deprescription (n = 119 patients). Demographic, clinical (pain, relief and adverse events) and therapeutic (analgesic use) outcomes were collected. Effectiveness (< 50 mg per day of morphine equivalent daily dose without any aberrant opioid use behaviour) and safety (number of side-effects) were analysed in relation to sex differences and pharmacogenetic markers impact [OPRM1 genotype (rs1799971) and CYP2D6 phenotypes]. Long-term opioid deprescription was achieved in 49 % of the patients with an increase in pain relief and a reduction of adverse events. CYP2D6 poor metabolizers showed the lowest long-term opioid doses. Here, women showed a higher degree of opioid deprescription, but increased use of tramadol and neuromodulators, as well as an increased number of adverse events. Long-term deprescription was successful in half of the cases. Understanding sex and gender interaction plus a genetic impact could help to design more individualized strategies for opioid deprescription.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones9702
https://acta.pharmaceutica.farmaceut.org/publications/2023-issue-1-acta-pharm-vol-73-2/
url https://isabial.portalinvestigacion.com/publicaciones9702
https://acta.pharmaceutica.farmaceut.org/publications/2023-issue-1-acta-pharm-vol-73-2/
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SCIENDO
publisher.none.fl_str_mv SCIENDO
dc.source.none.fl_str_mv ACTA PHARMACEUTICA
ISSN: 13300075
ISSNe: 18469558
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
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