Review
Health Care Sciences & Services
Marco Cascella, Federica Monaco, Davide Nocerino, Elisabetta Chine, Roberta Carpenedo, Paola Picerno, Laura Migliaccio, Angela Armignacco, Giulia Franceschini, Sergio Coluccia, Piergiacomo Di Gennaro, Maura C. Tracey, Cira A. Forte, Mariangela Tafuri, Anna Crispo, Francesco Cutugno, Alessandro Vittori, Silvia Natoli, Arturo Cuomo
Summary: The study conducted a bibliometric network analysis on the use of ROOs for BTcP treatment, revealing trends in published articles, distribution in journals, and main research topics. Most articles focused on the efficacy of ROOs, while abuse and misuse issues were not sufficiently addressed. Additionally, the semantic network analysis showed connections between breakthrough cancer pain, opioids, and cancers.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
(2022)
Article
Pharmacology & Pharmacy
Sebastiano Mercadante, Russell K. Portenoy
Summary: Breakthrough cancer pain (BTcP) is a complex phenomenon that varies between individuals and may change over time. Personalized management requires appropriate assessment of BTcP patterns. The use of opioids, specifically fentanyl products with rapid onset and offset, is recommended. The optimal opioid dose remains a controversial topic, with conflicting recommendations regarding dosing strategies.
Article
Health Care Sciences & Services
Tsung-Che Wu, Chih-Hung Hsu, Wei-Zen Sun, Ho-Min Chen, Chih-Peng Lin, Yu-Yun Shao
Summary: The introduction of new strong opioids in Taiwan led to changes in opioid prescription patterns for cancer pain management, aligning more with international guidelines. While the use of strong opioids increased, the use of weak opioids decreased.
LANCET REGIONAL HEALTH-WESTERN PACIFIC
(2021)
Article
Pharmacology & Pharmacy
Antti Valtola, Maisa Laakso, Henriikka Hakomaki, Brian J. Anderson, Hannu Kokki, Veli-Pekka Ranta, Valtteri Rinne, Merja Kokki
Summary: The study evaluated the use of intranasal fentanyl for managing breakthrough pain in cardiac bypass surgery patients. Results showed high bioavailability, rapid onset of analgesia, and a negative correlation with skeletal muscle mass and total body water. Intranasal fentanyl provided effective pain relief and can be an appropriate treatment option for early postoperative breakthrough pain.
CLINICAL PHARMACOKINETICS
(2021)
Article
Biochemistry & Molecular Biology
Piotr F. J. Lipinski, Joanna Matalinska
Summary: The design of multitarget analgesics is a strategy in the search for safe and effective analgesic drugs. These drugs are intended to target multiple molecular targets involved in pain modulation. This article summarizes attempts to use fentanyl or its substructures as a scaffold for attaching fragments related to non-opioid receptors. The non-opioid targets include various proteins. The article reviews the chemistry, pharmacological properties, and structure-activity relationships of these attempts, and discusses future research directions.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Oncology
Albert Tuca Rodriguez, Miguel Nunez Viejo, Pablo Maradey, Jaume Canal-Sotelo, Placido Guardia Mancilla, Sonia Gutierrez Rivero, Inmaculada Raja Casillas, Maria Herrera Abian, Cristina Lopez Bermudo
Summary: Individualized management of breakthrough cancer pain (BTcP) can improve quality of life (QoL) for patients with advanced cancer, with transmucosal fentanyl at low doses being the most common drug used.
SUPPORTIVE CARE IN CANCER
(2021)
Review
Medicine, General & Internal
Mia Elena Koponen, Patrice Forget
Summary: This study aimed to investigate pharmacological interventions for opioid-induced hyperalgesia caused by different opioids. The majority of interventions were studied in only one trial, with the most common mechanism being the inhibition of N-methyl-D-aspartate (NMDA) receptors.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Mehdi Nasr Isfahani, Omid Shokoohi, Keihan Golshani
Summary: This study compared the effect of intranasal ketamine versus intranasal fentanyl on pain management in isolated traumatic patients. The study found that the visual analog scale (VAS) scores of patients in the intranasal ketamine group were significantly lower than those in the control group and the intranasal fentanyl group at 5 and 10 minutes after intervention, with an onset of action within 10 minutes. Intranasal ketamine can be proposed as an appropriate analgesic medication for patients with isolated limb injuries, with a slightly higher incidence rate and severity of adverse effects compared to the intranasal fentanyl group.
JOURNAL OF RESEARCH IN MEDICAL SCIENCES
(2022)
Article
Oncology
Albert Tuca Rodriguez, Miguel Nunez Viejo, Pablo Maradey, Jaume Canal-Sotelo, Placido Guardia Mancilla, Sonia Gutierrez Rivero, Inmaculada Raja Casillas, Maria Herrera Abian, Cristina Lopez Bermudo
Summary: The study demonstrated that low-dose sublingual fentanyl effectively reduced breakthrough cancer pain in advanced cancer patients in palliative care units in Spain, significantly improving quality of life.
Article
Chemistry, Multidisciplinary
Tair Lapidot, Mohammed Bouhajib, Janice Faulknor, Shabaz Khan, Galia Temtsin Krayz, Carolina Abrutzky, Dalia Megiddo
Summary: This study compares the pharmacokinetics and safety of a new intranasal powder-based naloxone formulation (FMXIN001) with Narcan (R) nasal liquid spray. The results show that FMXIN001 has higher exposure and is well tolerated. It is expected to have a shorter onset of action for a more effective management of opioid overdose.
PHARMACEUTICAL RESEARCH
(2022)
Review
Clinical Neurology
Paolo Bossi, Yolanda Escobar, Federico Pea
Summary: This article discusses specific considerations for the use of rapid-onset opioids (ROOs) in treating breakthrough cancer pain (BTcP). ROOs are considered the most suitable drugs for BTcP and can be used on-demand. A dose-proportional scheme is believed to be safe and effective in most patients. Specific formulations may be more suitable for certain patient subgroups. Overcoming barriers to pain management is key for successful BTcP treatment.
FRONTIERS IN PAIN RESEARCH
(2022)
Article
Emergency Medicine
Raoul Daoust, Jean Paquet, Verilibe Huard, Jean-Marc Chauny, Gilles Lavigne, David Williamson, Manon Choiniere, Eddy Lang, Justin W. Yan, Jeffrey J. Perry, Marcel Emond, Sophie Gosselin, Alexis Cournoyer
Summary: This study aimed to evaluate the relationship between emergency department (ED) acute pain management with fentanyl compared to other opioids, and the quantity of opioids consumed by patients two weeks after discharge. The results showed that patients treated with fentanyl during their ED stay did not consume more opioids after ED discharge, compared to those treated with other opioids.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Review
Biochemistry & Molecular Biology
Shan Liu, Wen-Jia Kang, Anna Abrimian, Jin Xu, Luca Cartegni, Susruta Majumdar, Patrick Hesketh, Alex Bekker, Ying-Xian Pan
Summary: The OPRM1 gene undergoes extensive alternative splicing to produce multiple splice variants with important pharmacological implications for the actions of opioid drugs. These variants can mediate distinct effects of various mu opioids and be targeted for the development of novel analgesics with potent efficacy against multiple types of pain while reducing side effects associated with traditional opiates.
Article
Medicine, General & Internal
Ryoko Kawanaka, Shoko Sakuma, Hiroshi Kokubun, Shuhei Tetsu, Yugo Tagaito, Toshio Igarashi, Shan-Guang Liang, Tomohiko Aoe
Summary: This study evaluated the effect of combined use of fentanyl and short-acting remifentanil on postoperative pain and pain thresholds. The results showed that the combination of both opioids caused hyperalgesia, and the pain threshold decreased significantly at 3 hours postoperatively regardless of the fentanyl dose.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Sebastiano Mercadante, Augusto Caraceni, Arturo Cuomo, Massimo Mammucari, Paolo Marchetti, Rocco Domenico Mediati, Silvia Natoli, Giuseppe Tonini
Summary: After one-month follow-up, cancer patients experienced a lower number of breakthrough pain episodes and peak intensity, potentially due to optimization of background analgesia. The principal characteristics of breakthrough pain did not change significantly, highlighting the importance of careful and continuous assessment for patients to alleviate the burden induced by breakthrough pain episodes.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Oncology
Stefano De Santis, Maria Domenica Simone, Sebastiano Mercadante, Rocco Domenico Mediati, Renato Vellucci, Paolo Marchetti, Giuseppe Tonini, Arturo Cuomo, Augusto Caraceni, Silvia Natoli, Grazia Armento, Livio Blasi, Massimo Mammucari
Summary: This study evaluated the effectiveness of the immediate-release fixed combination of oxycodone/acetaminophen for cancer patients with background and breakthrough pain. The results showed that the combination provided adequate analgesia for moderate-severe background cancer pain. The characteristics of breakthrough cancer pain differed between the two groups, with group A showing lower intensity and faster onset compared to group B.
CANCER MANAGEMENT AND RESEARCH
(2021)
Review
Health Care Sciences & Services
Alberto Migliore, Gianfranco Gigliucci, Raffaele Di Marzo, Domenico Russo, Massimo Mammucari
Summary: The narrative review suggests that fractional intradermal vaccination can be an effective and efficient strategy for certain vaccines such as influenza, rabies, and hepatitis B. More research is needed for vaccines against other pathogens, but initial findings are promising. During a shortage of COVID-19 vaccines, exploring fractional dosing schemes could help save doses and achieve herd immunity quickly.
RISK MANAGEMENT AND HEALTHCARE POLICY
(2021)
Article
Clinical Neurology
Giustino Varrassi, Flaminia Coluzzi, Vittorio A. Guardamagna, Filomena Puntillo, Giovanni Sotgiu, Renato Vellucci
Summary: A Delphi study among Italian palliative care specialists revealed discrepancies in the use of strong opioids for cancer pain treatment, with consensus reached on the use of low dose of strong opioids in moderate pain treatment and the effectiveness of transdermal route as an alternative.
Review
Chemistry, Medicinal
Massimo Mammucari, Teresa Paolucci, Domenico Russo, Enrica Maggiori, Raffaele Di Marzo, Alberto Migliore, Umberto Massafra, Gianpaolo Ronconi, Paola Emilia Ferrara, Fabio Gori, Barbara Bifarini, Stefano Brauneis, Renato Vellucci, Rocco Domenico Mediati, Bartolomeo Violo, Silvia Natoli, Carmen Pediliggieri, Cristiana Di Campli, Maria Chiara Collina
Summary: Mesotherapy is a technique used to slowly spread drugs in tissues underlying the injection site to prolong the pharmacological effect. While there are recommendations for proper medical use, unresolved questions remain and new research is needed to test its safety and efficacy.
DRUG DESIGN DEVELOPMENT AND THERAPY
(2021)
Article
Medicine, General & Internal
Sebastiano Mercadante, Augusto Caraceni, Arturo Cuomo, Massimo Mammucari, Paolo Marchetti, Rocco Domenico Mediati, Silvia Natoli, Giuseppe Tonini
Summary: After one-month follow-up, cancer patients experienced a lower number of breakthrough pain episodes and peak intensity, potentially due to optimization of background analgesia. The principal characteristics of breakthrough pain did not change significantly, highlighting the importance of careful and continuous assessment for patients to alleviate the burden induced by breakthrough pain episodes.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Multidisciplinary Sciences
Stefano Bastianini, Viviana Lo Martire, Sara Alvente, Chiara Berteotti, Gabriele Matteoli, Laura Rullo, Serena Stamatakos, Alessandro Silvani, Sanzio Candeletti, Patrizia Romualdi, Gary Cohen, Giovanna Zoccoli
Summary: Early-life exposure to nicotine and its metabolite cotinine can lead to long-lasting reprogramming of hippocampal activity and sleep phenotype in adult mice. Nicotine and cotinine exposure resulted in increased wakefulness at the transition between rest and activity period, along with downregulation of hippocampal glucocorticoid receptor expression. These findings suggest that events during early life critical period may modulate adult sleep phenotype.
SCIENTIFIC REPORTS
(2021)
Article
Environmental Sciences
Marco Cascella, Franco Marinangeli, Alessandro Vittori, Cristina Scala, Massimo Piccinini, Alessandro Braga, Luca Miceli, Renato Vellucci
Summary: Telemedicine offers a significant opportunity to improve care for patients with chronic pain, enhancing monitoring, treatment adherence, and personalized treatment. However, challenges remain in identifying assessment tools, implementing monitoring instruments, and finding the right balance between in-person visits and telemedicine. Additional data and dynamic protocols are needed to establish effective care pathways in chronic pain management.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2021)
Review
Clinical Neurology
Flaminia Coluzzi, Laura Rullo, Maria Sole Scerpa, Loredana Maria Losapio, Monica Rocco, Domenico Billeci, Sanzio Candeletti, Patrizia Romualdi
Summary: The safety of opioids has been a major concern, prompting extensive research into multi-mechanistic opioids such as tapentadol and buprenorphine as valid alternatives to traditional opioids. The nociceptin opioid peptide (NOP) receptor plays a key role in analgesia and improved tolerability. New drugs such as buprenorphine and cebranopadol are being evaluated for their potential as safer options compared to traditional opioids.
Article
Clinical Neurology
F. Bavato, S. Stamatakos, C. M. Yde Ohki, E. Seifritz, P. Romualdi, E. Grunblatt, B. B. Quednow
Summary: The use of MDMA has been linked to alterations in the brain's serotonergic system, and this study investigates the molecular mechanisms behind these changes. The study finds that levels of neurofilament light chain (NfL) may be affected by MDMA, and that brain-derived neurotrophic factor (BDNF) plays a crucial role in preventing MDMA-induced damage to serotonin-producing neurons. These findings have implications for neuroprotective interventions and monitoring drug-induced neurotoxicity.
JOURNAL OF NEURAL TRANSMISSION
(2022)
Review
Pharmacology & Pharmacy
Fabio Vivarelli, Silvia Granata, Laura Rullo, Matilde Mussoni, Sanzio Candeletti, Patrizia Romualdi, Carmela Fimognari, Ivan Cruz-Chamorro, Antonio Carrillo-Vico, Moreno Paolini, Donatella Canistro
Summary: Research has shown that e-cigarette consumption may pose various health risks, including carcinogenic effects, respiratory and cardiovascular diseases, as well as risks to fertility and pregnancy.
PHARMACOLOGICAL RESEARCH
(2022)
Article
Endocrinology & Metabolism
Luca Posa, Danilo De Gregorio, Martha Lopez-Canul, Qianzi He, Emmanuel Darcq, Laura Rullo, Leora Pearl-Dowler, Livio Luongo, Sanzio Candeletti, Patrizia Romualdi, Brigitte Lina Kieffer, Gabriella Gobbi
Summary: In this study, the relationship between melatonin MT2 receptors and the opioid system in neuropathic pain was investigated. The results showed that the antiallodynic effects of a melatonin MT2 agonist required the activation of mu opioid receptors (MORs), but not delta opioid receptors (DORs). Electrophysiological recordings and immunohistochemistry studies revealed that the interaction between MORs and MT2 receptors within a neuronal circuit in the brain was responsible for the analgesic effects of the MT2 agonist.
JOURNAL OF PINEAL RESEARCH
(2022)
Review
Medicine, General & Internal
Renato Vellucci, Diego Fornasari
Summary: Tapentadol is an atypical opioid with improved gastrointestinal tolerability. This article provides an overview of opioid therapy in non-cancer pain, focusing on tapering of tapentadol in patients with chronic non-cancer pain. A flow chart is provided to guide clinicians in tapering tapentadol treatment based on individual patient characteristics and response to dosage reduction. Tapering strategies for tapentadol need further research.
CURRENT MEDICAL RESEARCH AND OPINION
(2023)
Article
Biochemistry & Molecular Biology
Lucia Carboni, Laura Rullo, Francesca Felicia Caputi, Serena Stamatakos, Sanzio Candeletti, Patrizia Romualdi
Summary: This study found that trazodone affects the expression of neurotrophic factors related to antidepressant responses and alters circadian rhythm genes associated with the pathophysiology of depression, shedding light on the molecular mechanism of action of trazodone.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Biochemistry & Molecular Biology
Laura Rullo, Francesca Felicia Caputi, Loredana Maria Losapio, Camilla Morosini, Luca Posa, Donatella Canistro, Fabio Vivarelli, Patrizia Romualdi, Sanzio Candeletti
Summary: This study investigated the impact of morphine, buprenorphine, and tapentadol on intracellular reactive oxygen species levels, superoxide dismutase activity/gene expression, as well as beta 2 and beta 5 subunit proteasome activity/biosynthesis in SH-SY5Y cells. The results showed that these opioids differently altered ROS production, SOD activity/biosynthesis, and proteasome activity/biosynthesis. The findings suggest that the differences in these cellular processes may contribute to the occurrence of opioid-related side effects.
