Non-steroidal anti-inflammatory drugs (NSAIDs) in cancer pain: A database analysis to determine recruitment feasibility for a clinical trial

Sage Palliative Medicine & Chronic Care

This episode features Dr Andrew Page (Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK).

Cancer pain is common, extremely debilitating, and undertreated worldwide. We do not know if non-steroidal anti-inflammatory drugs (aka NSAIDs or “anti-inflammatories”) are effective in managing cancer pain of any type. To further scientific understanding, UK palliative care doctors advocate a pragmatic trial to determine the role, if any, of NSAIDs as opioid adjuncts for treating cancer-induced bone pain. Numbers treated for cancer-induced bone pain at a single regional radiotherapy centre (478 per year) support the feasibility of trial recruitment. Considering eGFR and contraindicating co-morbidities, two-thirds could be suitable for NSAID prescription if proven efficacious. Suitability for NSAID prescription reduces with age, with the proportion unsuitable increasing in those over 65 years old. Recruitment to a future trial of NSAIDs in the management of cancer-induced bone pain appears feasible, particularly if multiple recruitment centres are used. Demonstrating feasibility allows the planning of a definitive clinical trial to determine the efficacy of NSAIDs in this patient group. Without a definitive clinical trial, the question remains: are effective analgesics being underutilised in cancer pain management, or are ineffective medications increasing the risk of side effects in an already co-morbid cancer population? Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221122263

If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: [email protected]