Literature DB >> 28449352

Effectiveness and Safety of Intrathecal Ziconotide: Interim Analysis of the Patient Registry of Intrathecal Ziconotide Management (PRIZM).

Timothy Deer1, Richard L Rauck2, Philip Kim3, Michael F Saulino4, Mark Wallace5, Eric J Grigsby6, I-Zu Huang7, Fannie Mori7, Geertrui F Vanhove7, Gladstone C McDowell8.   

Abstract

BACKGROUND: The Patient Registry of Intrathecal Ziconotide Management (PRIZM) evaluated long-term effectiveness, safety, and tolerability of intrathecal ziconotide treatment in clinical practice.
METHODS: Patient Registry of Intrathecal Ziconotide Management was an open-label, long-term, multicenter, observational study of adult patients with severe chronic pain. This interim analysis (data through July 10, 2015) of ziconotide as the first vs. not first intrathecal agent in pump included change from baseline in the Numeric Pain Rating Scale (NPRS; primary efficacy measure) and Patient Global Impression of Change (PGIC) scores.
RESULTS: Enrollment closed at 93 patients; data collection was ongoing at the time of this interim analysis. Fifty-one patients (54.8%) received ziconotide as the first agent in pump (FIP+), whereas 42 (45.2%) did not (FIP-). Mean (SD) baseline NPRS scores were 7.4 (1.9) and 7.9 (1.6) in FIP+ and FIP- patients, respectively. Mean (SEM) percentage changes in NPRS scores were -29.4% (5.5%) in FIP+ patients (n = 26) and +6.4% (7.7%) in FIP- patients (n = 17) at month 6 and -34.4% (9.1%) in FIP+ patients (n = 14) and -3.4% (10.2%) in FIP- patients (n = 9) at month 12. Improvement from baseline, measured by PGIC score, was reported in 69.2% of FIP+ (n = 26) and 35.7% of FIP- (n = 14) patients at month 6 and 85.7% of FIP+ (n = 7) and 71.4% of FIP- (n = 7) patients at month 12. The most common adverse events (≥ 10% of patients overall as of the data cut) were nausea (19.6% vs. 7.1% of FIP+ vs. FIP- patients, respectively), confusional state (9.8% vs. 11.9%), and dizziness (13.7% vs. 7.1%).
CONCLUSIONS: Greater improvements in efficacy outcomes were observed when ziconotide was initiated as first-line intrathecal therapy vs. not first intrathecal agent in pump. The adverse event profile was consistent with the ziconotide prescribing information.
© 2017 World Institute of Pain.

Entities:  

Keywords:  chronic pain; intrathecal implantable drug delivery system; observational study; ziconotide

Mesh:

Substances:

Year:  2017        PMID: 28449352     DOI: 10.1111/papr.12599

Source DB:  PubMed          Journal:  Pain Pract        ISSN: 1530-7085            Impact factor:   3.183


  10 in total

Review 1.  Intrathecal ziconotide: a review of its use in patients with chronic pain refractory to other systemic or intrathecal analgesics.

Authors:  Mark Sanford
Journal:  CNS Drugs       Date:  2013-11       Impact factor: 5.749

Review 2.  Mirogabalin and emerging therapies for diabetic neuropathy.

Authors:  Saad Javed; Uazman Alam; Rayaz A Malik
Journal:  J Pain Res       Date:  2018-08-22       Impact factor: 3.133

3.  Near-resolution of persistent idiopathic facial pain with low-dose lumbar intrathecal ziconotide: a case report.

Authors:  Brandon P Staub; Gianna P Casini; Edward A Monaco; Raymond F Sekula; Trent D Emerick
Journal:  J Pain Res       Date:  2019-03-08       Impact factor: 3.133

Review 4.  Intrathecal Therapy for Chronic Pain: A Review of Morphine and Ziconotide as Firstline Options.

Authors:  Timothy R Deer; Jason E Pope; Michael C Hanes; Gladstone C McDowell
Journal:  Pain Med       Date:  2019-04-01       Impact factor: 3.750

Review 5.  Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient.

Authors:  Jose De Andres; Salim Hayek; Christophe Perruchoud; Melinda M Lawrence; Miguel Angel Reina; Carmen De Andres-Serrano; Ruben Rubio-Haro; Mathew Hunt; Tony L Yaksh
Journal:  Front Pain Res (Lausanne)       Date:  2022-06-16

6.  Structure of human Cav2.2 channel blocked by the painkiller ziconotide.

Authors:  Shuai Gao; Xia Yao; Nieng Yan
Journal:  Nature       Date:  2021-07-07       Impact factor: 49.962

Review 7.  Marine Toxins and Nociception: Potential Therapeutic Use in the Treatment of Visceral Pain Associated with Gastrointestinal Disorders.

Authors:  Andreina Baj; Michela Bistoletti; Annalisa Bosi; Elisabetta Moro; Cristina Giaroni; Francesca Crema
Journal:  Toxins (Basel)       Date:  2019-07-31       Impact factor: 4.546

8.  Intrathecal pain management with ziconotide: Time for consensus?

Authors:  Georgios Matis; Pasquale De Negri; Denis Dupoiron; Rudolf Likar; Xander Zuidema; Dirk Rasche
Journal:  Brain Behav       Date:  2021-03       Impact factor: 2.708

9.  [What became of Prialt®? : Observational study on the use of ziconotide in the treatment of chronic pain].

Authors:  Denise Löschner; Rebecca Dries; Rolf Kalff; Jan Walter; Rupert Reichart
Journal:  Schmerz       Date:  2021-01-28       Impact factor: 1.107

10.  Short-Term Outcomes of a High-Volume, Low-Concentration Bolus Starting Dose Technique With Ziconotide: A Case Series.

Authors:  David Lindley
Journal:  Neuromodulation       Date:  2021-07-12
  10 in total

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