Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Long-term opioid treatment and endocrine measures in chronic non-cancer pain patients: A systematic review and meta-analysis

Publikation: Bidrag til tidsskriftReviewForskningpeer review

DOI

  1. Von Frey testing revisited - provision of an online algorithm for improved accuracy of 50% thresholds

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Medication-overuse headache: The effect of a patient educational programme-A randomized controlled trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Complete withdrawal is the most feasible treatment for medication-overuse headache: A randomized controlled open-label trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. HIV infection is associated with type 2 diabetes mellitus

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  2. Brain tumours in children and adolescents may affect the circadian rhythm and quality of life

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Early specialised palliative care: interventions, symptoms, problems

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND AND OBJECTIVE: Long-term opioid treatment (L-TOT) of chronic non-cancer pain (CNCP) patients has been suspected to alter the endocrine system. This systematic review and meta-analysis aimed at investigating the published evidence of L-TOT effects on the endocrine system in adult CNCP patients.

DATABASES AND DATA TREATMENT: A systematic search of the literature in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and the CINAHL was performed. Studies examining measures of endocrine function of the hypothalamic-pituitary-gonadal, -adrenal, -thyroid, -somatotropic and -prolactin axis in adult CNCP patients in L-TOT (≥4 weeks of use) were included. Outcomes and the level of evidence were analyzed (The Cochrane Collaboration Tool, modified version of the Newcastle-Ottawa Scale and Rating of Recommendations Assessment, Development and Evaluation working group).

RESULTS: A total of 2,660 studies were identified; 1981 excluded and finally thirteen studies (one randomized controlled trial (RCT), three longitudinal- and nine cross-sectional studies) were analyzed. L-TOT was associated with low insulin, suppression of the hypothalamic-pituitary-gonadal axis and alterations of the hypothalamic-pituitary-adrenal axis in both men and women with CNCP compared to different control groups (CNCP or healthy pain-free). No other significant differences were reported. The studies had a high risk of bias and the overall quality of evidence was low.

CONCLUSION: There seems to be an impact of L-TOT in CNCP patients on several components of the endocrine system, but the level of evidence is weak. Given the high prevalence of L-TOT use systematic studies of larger patient populations are urgently needed.

SIGNIFICANCE: This systematic review and meta-analysis suggested that long-term opioid treatment may suppress the hypothalamic-pituitary-gonadal axis, and result in lower insulin levels and alter the glucocorticoid adrenal axis in adult chronic non-cancer pain patients. This adds to the need of more research of both clinical and paraclinical outcomes and their association when initiating and maintaining long-term opioid treatment.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Pain
Vol/bind25
Udgave nummer9
Sider (fra-til)1859-1875
Antal sider17
ISSN1090-3801
DOI
StatusUdgivet - okt. 2021

ID: 65654229