Evidence map›Paper›PMID 28597312›Full record

Observational studySchmerz (Berlin, Germany)2017

[Management of chronic pain using extended release tilidine : Quality of life and implication of comedication on tilidine metabolism].

C Wolfert, M Merbach, G Stammler, O Emrich, A D Meid, J Burhenne, A Blank, G Mikus

Erratum issuedAbstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Schmerz (Berlin, Germany), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. The Mechanisms Involved in Morphine Addiction: An Overview.International journal of molecular sciences · 2019
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

C WolfertAbteilung für Klinische Pharmakologie und Pharmakoepidemiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland.
M MerbachSt. Marien- und St. Annastiftskrankenhaus, Ludwigshafen, Deutschland.
G StammlerSt. Marien- und St. Annastiftskrankenhaus, Ludwigshafen, Deutschland.
O EmrichPraxis für Allgemeinmedizin - spezielle Schmerztherapie, Schmerzzentrum Ludwigshafen, Ludwigshafen, Deutschland.
A D MeidAbteilung für Klinische Pharmakologie und Pharmakoepidemiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland.
J BurhenneAbteilung für Klinische Pharmakologie und Pharmakoepidemiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland.
A BlankAbteilung für Klinische Pharmakologie und Pharmakoepidemiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland.
G MikusAbteilung für Klinische Pharmakologie und Pharmakoepidemiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland. gerd.mikus@med.uni-heidelberg.de.
University Hospital Heidelberg · DEHeidelberg University · DESt. Marien- und St. Annastiftskrankenhaus · DEKlinikum Ludwigshafen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe synthetic opioid tilidine is often used in chronic pain treatment. However, the activation via metabolism in patients with concomitant medication and reduced liver or kidney function is not thoroughly investigated. We therefore studied pain treatment efficacy, health-related quality of live and the metabolism of tilidine in patients with chronic pain. METHODS AND MATERIALS: In all, 48 patients, who were on a stable dose of oral prolonged release tilidine for at least 7 days, were included in this observational multicenter study. Liver and kidney function were assessed in routine blood samples, concentrations of tilidine, nortilidine and bisnortilidine were determined using a validated LC/MS/MS method. Comedication was registered and patients experience with regard to quality of life, pain, gastrointestinal symptoms and adverse events was assessed in standardised questionnaires.

resultsOn average a daily dose of 180 mg tilidine was taken. Dose normalized plasma concentrations of the active metabolite nortilidine ranged between 1.6 ng/ml and 76.5 ng/ml (mean 29.2 ± 25.1 ng/ml). Ratios between tilidine and nortilidine were on average 0.28 (median = 0.13, standard deviation = 0.67). Patients were on 1 to 14 different concomitant medications. About 66% of the patients had sufficient pain treatment. Almost no opioid-induced constipation was observed. Only few patients had decreased kidney or liver function which did not result in elevated nortilidine concentrations.

conclusionPain treatment using tilidine resulted in variable nortilidine concentrations which are obviously not strongly influenced by comedication or reduced liver or kidney function. Only a few side effects were observed with almost no opioid-induced constipation.

Indexed as

AdultAgedAged, 80 and overChronic PainDelayed-Action PreparationsDrug InteractionsDrug Therapy, CombinationFemaleHumansKidney Function TestsLiver Function TestsMaleMiddle AgedQuality of LifeTilidinebisnortilidineDelayed-Action PreparationsnortilidineTilidineChronic painComedicationMetabolismQuality of lifeTilidine

Identifiers

PMID28597312
OpenAlexW2622748242

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.