Retrospective cohort study on pain management using global standard-dose acetaminophen in 182 patients treated for cancer pain

ABSTRACT

<b>Purpose and Methods</b> In the WHO guidelines on the management of cancer pain, global standard-dose acetaminophen (APAP) is described as a first-line drug, but there have been few studies comparing the efficacy and safety of APAP with other options in Japan. We retrospectively studied the efficacy and safety of global standard-dose APAP in the management of cancer pain, by comparing 182 patients treated with global standard-dose APAP (1,800-2,400 mg/day) (APAP group) and 86 patients treated with NSAIDs (NSAIDs group) at our clinic. <b>Results</b> As the result, the management of cancer pain was comparable between the APAP group and the NSAIDs group. Despite the lack of sufficient investigation of concomitant drug such as opioids, etc., global standard-dose APAP was not inferior to NSAIDs in terms of efficacy as a non-opioid analgesic for the treatment of cancer pain. When we compared safety between the APAP group and the NSAIDs group, the incidence of nausea was significantly lower in the APAP group (<i>p</i><0.01), while the percentage of patients with AST/ALT levels 2.5 times higher than at baseline was comparable in the 2 groups. <b>Conclusion</b> Based on the above efficacy and safety results, global standard-dose APAP was concluded to be a useful non-opioid analgesic option for the treatment of cancer pain in Japan. Palliat Care Res 2011; 6(2) 133-142