SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
The role of combined adjuvant therapeutic drugs in modulating opioid dosage and pain status in cancer patients: a systematic review and meta-analysis.
Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- The interplay of circadian rhythms and cancer pain: a narrative review.Journal of anesthesia, analgesia and critical care · 2026Review
- Pharmacological Management of Cancer Pain: Advances in Treatment Strategies and Drug Delivery Systems.Pharmaceutics · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundThe management of cancer-related pain primarily relies on opioid analgesics, yet their use is frequently complicated by adverse effects and inadequate pain relief at higher doses.
objectivesTo assess the effectiveness and safety of adjunctive medications in reducing opioid requirements and improving pain management in patients with cancer-related pain.
methodsA comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library up to June 2024, encompassing all relevant records. Studies were included if they were randomized controlled trials (RCTs) or observational studies that compared the efficacy of combined adjuvant therapy with monotherapy using opioid analgesics for the management of cancer-related pain in adults and reported at least one pertinent outcome measure.
resultsThis analysis included 13 studies (10 RCTs, n = 711; 3 retrospective studies, n = 314) evaluating adjunctive therapies including NSAIDs, anticonvulsants, antidepressants, and corticosteroids. Combination therapy significantly reduced daily opioid consumption versus monotherapy ([MD] -18.84 mg; 95% CI -28.19 to -9.52; P < 0.0001), with significant reductions specifically for NSAIDs (MD -17.27; 95% CI -30.26 to -4.27; P = 0.009) and anticonvulsants (MD -28.02; 95% CI -47.42 to -8.62; P = 0.005). Adjunctive therapy also significantly improved pain scores with NSAIDs (MD -0.79; 95% CI -0.97 to -0.62; P < 0.00001), dexamethasone (MD -1.43; 95% CI -2.23 to -0.63; P = 0.0004), and anticonvulsants (MD -0.23; 95% CI -0.42 to -0.03; P = 0.02). NSAIDs and antidepressants reduced dizziness (OR 0.34; 95% CI 0.19-0.59; P = 0.0002), while anticonvulsants increased its risk (OR 3.55; 95% CI 1.98-6.39; P < 0.0001). NSAIDs were associated with lower drowsiness (OR 0.28; 95% CI 0.13-0.57; P = 0.0005), whereas anticonvulsants and antidepressants increased drowsiness incidence (OR 3.49; 95% CI 2.02-6.01; P < 0.00001). No significant differences were observed in nausea/vomiting (OR 0.80; P = 0.19) or constipation (OR 0.73; P = 0.53). Meta-analysis of safety outcomes revealed no significant increase in the risk of serious adverse events with combination therapy compared to opioid monotherapy. DISCUSSION: The findings indicate that combined adjuvant therapy exhibits favorable efficacy and safety profiles in the management of cancer pain. Nevertheless, the selection of drug combinations requires an individualized approach. Future research should focus on further exploring optimized combination strategies to enhance the therapeutic effect.
conclusionThe findings indicate that combined adjuvant therapy exhibits favorable efficacy and safety profiles in the management of cancer pain.
Indexed as
Identifiers
41074978What OpenQuestion holds
Registered trials
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.