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conferenceseries.com
Volume 8 Journal of Palliative Care & Medicine Hospice 2018
July 18-19, 2018
July 18-19, 2018 Melbourne, Australia
5th World Congress on
Hospice and Palliative Care
Efficacy of the addition of duloxetine for neuropathic cancer pain refractory to opioids and
gabapentinoids: A multi-institutional, randomized, double-blinded, placebo-controlled trial (JORTC
Pal 08 (trials in progress)
Hiromichi Matsuoka1,2
1University of Technology Sydney, Australia
2Kindai University, Japan
Management of cancer patients suffering from neuropathic pain refractory to opioids and gabapentinoids remains an
important challenge. Duloxetine is one of the choices after first-line treatment fails. The efficacy of duloxetine has
been reported in non-cancer patients and in chemotherapy-induced polyneuropathy, but no randomized clinical trials
have examined its effects on neuropathic cancer pain refractory to first-line treatment. A multi-institutional, prospective,
randomized, double-blind, placebo-controlled, two-parallel trial is planned. The inclusion criteria are adult cancer patients
suffering from neuropathic pain refractory to opioids and gabapentinoids, patients with a Numerical Rating Scale (NRS) pain
score of 4 or higher and patients with a total Hospital Anxiety and Depression Scale (HADS) score of less than 20. Patients with
chemotherapy-induced peripheral neuropathy are excluded. The study will take place at 14 sites across Japan. Participants will
be randomized (1:1 allocation ratio) to a duloxetine intervention group or a placebo control group. Evaluations will be made at
baseline (T0 randomization), day 0 (T1), day 3 (T2) and day 10 (T3). The primary endpoint is defined as the difference in NRS
score for pain intensity (average over the previous 24 hours) at T3 between the duloxetine and placebo groups. The enrolment
started in July 2015. At the time of manuscript submission (November 2017), more than 95% of patients have participated. We
thus expect to complete the recruitment by December 2017. Treatment of neuropathic pain in cancer patients represents an
area of high unmet medical need. To our knowledge, there has been no randomized study of the analgesic efficacy of duloxetine
in patients with neuropathic cancer pain refractory to opioids and gabapentinoids. This study of duloxetine in neuropathic
pain refractory to opioids and gabapentinoids will be the first registered trial of therapy for this condition.
Biography
Hiromichi Matsuoka has expertise in evaluation and passion in improving the health and well-being. He is currently working as a Visiting Professor in University
of Technology Sydney and preceding his research in patients with cancer pain. He has built his backgrounds as an Anesthesiologist, Physician of Psychosomatic
Medicine and Palliative Care Doctors after years of experience in research, evaluation and teaching both in hospitals and educational institutions.
Hiromichi Matsuoka, J Palliat Care Med 2018, Volume 8
DOI: 10.4172/2165-7386-C1-015