Abstract
Oxcarbazepine for Head and Neck Cancer-Related Pain in Ambulatory Patients Receiving Palliative Care
Journal of pain and symptom management, Vol.67(5), pp.e691-e691
05/2024
DOI: 10.1016/j.jpainsymman.2024.02.159
Abstract
1. Recognize the opportunities of utilizing oxcarbazepine for the management of head and neck cancer-related pain.
2. Recognize the limitations of utilizing oxcarbazepine for the management of head and neck cancer-related pain.
Oxcarbazepine may be a safe and efficacious option for the management for head and neck cancer related pain. Learning from a single-center review of prescribing trends how oxcarbazepine can be considered as part of a multimodal analgesic regimen in this patient population.
Oxcarbazepine, a sodium channel antagonist, can be effective in palliating neuropathic pain associated with head and neck conditions. However, data is lacking to support oxcarbazepine's safety and efficacy for head and neck cancer (HNC)-related pain.
*Determine the frequency of oxcarbazepine prescribing for HNC-related pain. *Analyze the safety considerations and analgesic efficacy of oxcarbazepine in patients with HNC.
An IRB-approved retrospective chart review was conducted on patients living with HNC seen in a palliative care clinic between 7/1/2016 and 12/31/2021. Patients were included if they were prescribed oxcarbazepine for HNC pain management. Exclusion criteria included patients younger than 18 years old, oxcarbazepine duration of three days or less, and lack of follow-up following oxcarbazepine initiation. Patient demographics, efficacy data (Edmonton Symptom Assessment Scale, ESAS, scores for pain and well-being), and safety data (ESAS scores for tiredness, drowsiness, and serum sodium levels), and oxcarbazepine prescription details were collected. Efficacy and safety data were evaluated before and after oxcarbazepine initiation. Descriptive statistics evaluated changes in efficacy and safety data. Paired and unpaired t-tests were utilized for statistical significance (p < 0.05 statistically significant).
One hundred seventy-three patients were included for analysis. Approximately 13% of patients were prescribed oxcarbazepine for management of HNC-related pain. There was no statistical difference in serum sodium levels and ESAS scores among patients prescribed oxcarbazepine versus those who were not. For patients prescribed oxcarbazepine (n=23), pain scores did not worsen with oxcarbazepine initiation and well-being scores improved by approximately one point (p=0.12). Sodium levels and tiredness and drowsiness scores did not significantly worsen.
Oxcarbazepine may be a safe and effective analgesic for the management of HNC, but it is infrequently prescribed. Patient-specific risk/benefit discussions should occur when considering oxcarbazepine as a part of multimodal analgesia for HNC-related pain.
Pharmacotherapeutics / Pharmacopalliation / Quality Improvement
Details
- Title: Subtitle
- Oxcarbazepine for Head and Neck Cancer-Related Pain in Ambulatory Patients Receiving Palliative Care
- Creators
- Lorin Fisher - University of IowaBryce Andry - University of Iowa College of PharmacySara Carr - University of Iowa College of PharmacyKylie Juenger - University of Iowa College of PharmacyHsin Lan Lin - University of Iowa College of Pharmacy
- Resource Type
- Abstract
- Publication Details
- Journal of pain and symptom management, Vol.67(5), pp.e691-e691
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jpainsymman.2024.02.159
- ISSN
- 0885-3924
- eISSN
- 1873-6513
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Pharmacy Practice and Science
- Record Identifier
- 9984618500802771
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