Refractory cachexia is associated with increased plasma concentrations of fentanyl in cancer patients

Manabu Suno, Yuriko Endo, Hiroyuki Nishie, Makoto Kajizono, Toshiaki Sendo, Junji Matsuoka

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: An appropriate plasma concentration of fentanyl is the key to achieving good pain control in cancer patients. Cachexia, a multifactorial syndrome, is known to affect drug-metabolizing enzymes. However, the fentanyl concentrations in the blood of patients with cachexia have not been analyzed. The aim of this study was to evaluate the influence of cancer cachexia on dose-adjusted plasma fentanyl concentrations in cancer patients. Methods: Blood was collected from 21 Japanese cancer patients treated with a 24-hour transdermal fentanyl patch during the steady state of fentanyl plasma concentration. Plasma fentanyl concentrations were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS), and the levels were adjusted with the dose of fentanyl. Laboratory data were collected, and the cachexia stage was determined, based on study by Fearon et al. Multiple regression analysis was performed to identify the factors that affected fentanyl plasma concentrations. Results: Eight patients were classified as precachexia, nine as cachexia, and four as refractory cachexia, and the median dose-adjusted fentanyl concentrations (ng/mL per mg/kg/day) were 27.5, 34.4, and 44.5, respectively. The dose-adjusted fentanyl concentration in patients with refractory cachexia was higher than that in patients with precachexia (Kruskal–Wallis test and post hoc Mann–Whitney U-test, P

Original languageEnglish
Pages (from-to)751-757
Number of pages7
JournalTherapeutics and Clinical Risk Management
Volume11
DOIs
Publication statusPublished - May 8 2015

Fingerprint

Cachexia
Fentanyl
Refractory materials
cancer
Plasmas
Neoplasms
Blood
Liquid chromatography
pain
regression analysis
Regression analysis
Mass spectrometry
drug
Enzymes
Transdermal Patch
Tandem Mass Spectrometry
Liquid Chromatography
Regression Analysis
Pain

Keywords

  • Cancer pain
  • LC-MS/MS
  • Transdermal patch

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Safety Research
  • Chemical Health and Safety

Cite this

Refractory cachexia is associated with increased plasma concentrations of fentanyl in cancer patients. / Suno, Manabu; Endo, Yuriko; Nishie, Hiroyuki; Kajizono, Makoto; Sendo, Toshiaki; Matsuoka, Junji.

In: Therapeutics and Clinical Risk Management, Vol. 11, 08.05.2015, p. 751-757.

Research output: Contribution to journalArticle

@article{57e1f62090e64e0eb0f5beeef50a3b99,
title = "Refractory cachexia is associated with increased plasma concentrations of fentanyl in cancer patients",
abstract = "Background: An appropriate plasma concentration of fentanyl is the key to achieving good pain control in cancer patients. Cachexia, a multifactorial syndrome, is known to affect drug-metabolizing enzymes. However, the fentanyl concentrations in the blood of patients with cachexia have not been analyzed. The aim of this study was to evaluate the influence of cancer cachexia on dose-adjusted plasma fentanyl concentrations in cancer patients. Methods: Blood was collected from 21 Japanese cancer patients treated with a 24-hour transdermal fentanyl patch during the steady state of fentanyl plasma concentration. Plasma fentanyl concentrations were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS), and the levels were adjusted with the dose of fentanyl. Laboratory data were collected, and the cachexia stage was determined, based on study by Fearon et al. Multiple regression analysis was performed to identify the factors that affected fentanyl plasma concentrations. Results: Eight patients were classified as precachexia, nine as cachexia, and four as refractory cachexia, and the median dose-adjusted fentanyl concentrations (ng/mL per mg/kg/day) were 27.5, 34.4, and 44.5, respectively. The dose-adjusted fentanyl concentration in patients with refractory cachexia was higher than that in patients with precachexia (Kruskal–Wallis test and post hoc Mann–Whitney U-test, P",
keywords = "Cancer pain, LC-MS/MS, Transdermal patch",
author = "Manabu Suno and Yuriko Endo and Hiroyuki Nishie and Makoto Kajizono and Toshiaki Sendo and Junji Matsuoka",
year = "2015",
month = "5",
day = "8",
doi = "10.2147/TCRM.S79374",
language = "English",
volume = "11",
pages = "751--757",
journal = "Therapeutics and Clinical Risk Management",
issn = "1176-6336",
publisher = "Dove Medical Press Ltd.",

}

TY - JOUR

T1 - Refractory cachexia is associated with increased plasma concentrations of fentanyl in cancer patients

AU - Suno, Manabu

AU - Endo, Yuriko

AU - Nishie, Hiroyuki

AU - Kajizono, Makoto

AU - Sendo, Toshiaki

AU - Matsuoka, Junji

PY - 2015/5/8

Y1 - 2015/5/8

N2 - Background: An appropriate plasma concentration of fentanyl is the key to achieving good pain control in cancer patients. Cachexia, a multifactorial syndrome, is known to affect drug-metabolizing enzymes. However, the fentanyl concentrations in the blood of patients with cachexia have not been analyzed. The aim of this study was to evaluate the influence of cancer cachexia on dose-adjusted plasma fentanyl concentrations in cancer patients. Methods: Blood was collected from 21 Japanese cancer patients treated with a 24-hour transdermal fentanyl patch during the steady state of fentanyl plasma concentration. Plasma fentanyl concentrations were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS), and the levels were adjusted with the dose of fentanyl. Laboratory data were collected, and the cachexia stage was determined, based on study by Fearon et al. Multiple regression analysis was performed to identify the factors that affected fentanyl plasma concentrations. Results: Eight patients were classified as precachexia, nine as cachexia, and four as refractory cachexia, and the median dose-adjusted fentanyl concentrations (ng/mL per mg/kg/day) were 27.5, 34.4, and 44.5, respectively. The dose-adjusted fentanyl concentration in patients with refractory cachexia was higher than that in patients with precachexia (Kruskal–Wallis test and post hoc Mann–Whitney U-test, P

AB - Background: An appropriate plasma concentration of fentanyl is the key to achieving good pain control in cancer patients. Cachexia, a multifactorial syndrome, is known to affect drug-metabolizing enzymes. However, the fentanyl concentrations in the blood of patients with cachexia have not been analyzed. The aim of this study was to evaluate the influence of cancer cachexia on dose-adjusted plasma fentanyl concentrations in cancer patients. Methods: Blood was collected from 21 Japanese cancer patients treated with a 24-hour transdermal fentanyl patch during the steady state of fentanyl plasma concentration. Plasma fentanyl concentrations were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS), and the levels were adjusted with the dose of fentanyl. Laboratory data were collected, and the cachexia stage was determined, based on study by Fearon et al. Multiple regression analysis was performed to identify the factors that affected fentanyl plasma concentrations. Results: Eight patients were classified as precachexia, nine as cachexia, and four as refractory cachexia, and the median dose-adjusted fentanyl concentrations (ng/mL per mg/kg/day) were 27.5, 34.4, and 44.5, respectively. The dose-adjusted fentanyl concentration in patients with refractory cachexia was higher than that in patients with precachexia (Kruskal–Wallis test and post hoc Mann–Whitney U-test, P

KW - Cancer pain

KW - LC-MS/MS

KW - Transdermal patch

UR - http://www.scopus.com/inward/record.url?scp=84930193288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84930193288&partnerID=8YFLogxK

U2 - 10.2147/TCRM.S79374

DO - 10.2147/TCRM.S79374

M3 - Article

AN - SCOPUS:84930193288

VL - 11

SP - 751

EP - 757

JO - Therapeutics and Clinical Risk Management

JF - Therapeutics and Clinical Risk Management

SN - 1176-6336

ER -