Universität zu Köln

Gaertner, Jan ORCID: 0000-0002-1176-3164, Stamer, Ulrike M., Remi, Constanze ORCID: 0000-0001-7655-0306, Voltz, Raymond, Bausewein, Claudia ORCID: 0000-0002-0958-3041, Sabatowski, Rainer ORCID: 0000-0003-2228-3147, Wirz, Stefan, Mueller-Mundt, Gabriele, Simon, Steffen T., Pralong, Anne, Nauck, Friedemann, Follmann, Markus ORCID: 0000-0003-3790-5578, Radbruch, Lukas and Meissner, Winfried (2017). Metamizole/dipyrone for the relief of cancer pain: A systematic review and evidence-based recommendations for clinical practice. Palliat. Med., 31 (1). S. 26 - 35. LONDON: SAGE PUBLICATIONS LTD. ISSN 1477-030X

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Abstract

Background: Dipyrone (metamizole) is one of the most widely used non-opioid analgesics for the treatment of cancer pain. Aim: Because evidence-based recommendations are not yet available, a systematic review was conducted for the German Guideline Program in Oncology to provide recommendations for the use of dipyrone in cancer pain. Design: First, a systematic review for clinical trials assessing dipyrone in adult patients with cancer pain was conducted. Endpoints were pain intensity, opioid-sparing effects, safety, and quality of life. Data sources: The search was performed in MedLine, Embase (via Ovid), and the Cochrane Library (1948-2013) and additional hand search was conducted. Finally, recommendations were developed and agreed in a formal structured consensus process by 53 representatives of scientific medical societies and 49 experts. Results: Of 177 retrieved studies, 4 could be included (3 randomized controlled trials and 1 cohort study, n=252 patients): dipyrone significantly decreased pain intensity compared to placebo, even if low doses (1.5-2g/day) were used. Higher doses (3x2g/day) were more effective than low doses (3x1g/day), but equally effective as 60mg oral morphine/day. Pain reduction of dipyrone and non-steroidal anti-inflammatory drugs did not differ significantly. Compared to placebo, non-steroidal anti-inflammatory drugs, and morphine, the incidence of adverse effects was not increased. Conclusion: Dipyrone can be recommended for the treatment of cancer pain as an alternative to other non-opioids either alone or in combination with opioids. It can be preferred over non-steroidal anti-inflammatory drugs due to the presumably favorable side effect profile in long-term use, but comparative studies are not available for long-term use.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gaertner, Jan UNSPECIFIED orcid.org/0000-0002-1176-3164 UNSPECIFIED Stamer, Ulrike M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Remi, Constanze UNSPECIFIED orcid.org/0000-0001-7655-0306 UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED Bausewein, Claudia UNSPECIFIED orcid.org/0000-0002-0958-3041 UNSPECIFIED Sabatowski, Rainer UNSPECIFIED orcid.org/0000-0003-2228-3147 UNSPECIFIED Wirz, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller-Mundt, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Steffen T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pralong, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Nauck, Friedemann UNSPECIFIED UNSPECIFIED UNSPECIFIED Follmann, Markus UNSPECIFIED orcid.org/0000-0003-3790-5578 UNSPECIFIED Radbruch, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, Winfried UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-247586
DOI:	10.1177/0269216316655746
Journal or Publication Title:	Palliat. Med.
Volume:	31
Number:	1
Page Range:	S. 26 - 35
Date:	2017
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	1477-030X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NONSTEROIDAL ANTIINFLAMMATORY DRUGS; BLOOD DYSCRASIAS; ORAL MORPHINE; DIPYRONE; AGRANULOCYTOSIS; PARACETAMOL; METAMIZOL; ACETAMINOPHEN; ANALGESICS; GERMANY Multiple languages Health Care Sciences & Services; Public, Environmental & Occupational Health; Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24758