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[Effectiveness of Topical NSAIDs in a Gastric Cancer Patient with Bone Metastasis Pain during Therapy with Opioids and Oral NSAIDs].

Abstract
Cancer patients often suffer from severe pain related to bone metastasis. We encountered a patient in whom the addition of topical non-steroidal anti-inflammatory drugs (NSAIDs) for persistent pain related to bone metastasis during therapy with opioids and oral NSAIDs reduced pain, improving activities of daily living (ADL). Fentanyl patches, celecoxib, denosumab, and topical NSAIDs (loxoprofen tape, felbinac) were administered to a 72-year-old patient with gastric cancer and pain related to bone metastasis. Pain control was favorable, with a numerical rating scale (NRS) score of 2 and Japanese version Support Team Assessment Schedule (STAS-J) score of 1. Intervention by pharmacists for the use of topical NSAIDs decreased both the NRS and STAS-J scores to zero, improving ADL. The results suggest that topical NSAIDs relieve bone-metastasis-related pain, improving ADL. When bone-metastasis-related pain is localized, the prescription of topical NSAIDs should be considered, and positive intervention by pharmacists regarding their usage should be promoted.
AuthorsKazutoshi Terayama, Mayumi Hamana, Masao Tsuchiya, Tamaki Watanabe, Hiromi Enomoto, Nobuhiro Yasuno, Kunihisa Miura, Kazuki Ohta, Shigekazu Watanabe
JournalYakugaku zasshi : Journal of the Pharmaceutical Society of Japan (Yakugaku Zasshi) Vol. 140 Issue 8 Pg. 1081-1085 ( 2020) ISSN: 1347-5231 [Electronic] Japan
PMID32741866 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
Topics
  • Activities of Daily Living
  • Administration, Oral
  • Administration, Topical
  • Aged
  • Analgesics, Opioid (administration & dosage)
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
  • Bone Neoplasms (complications, physiopathology, secondary)
  • Cancer Pain (drug therapy, etiology)
  • Drug Therapy, Combination
  • Humans
  • Male
  • Stomach Neoplasms (pathology)
  • Treatment Outcome

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