Oral ketamine does not ease cancer-related neuropathic pain
medwireNews: A UK trial rules out the use of oral ketamine for the general treatment of chronic neuropathic pain in patients with cancer.
The primary endpoint of duration of analgesic benefit – defined as an improvement from baseline of at least 5 points in the Sensory Component of the Short Form McGill Pain Questionnaire score – over 16 days of treatment did not differ significantly between the 107 patients who were randomly assigned to receive ketamine and the 107 given placebo.
Secondary outcomes, including the effects on anxiety, depression, distress, and quality of life, were also comparable between study arms, report Marie Fallon, from the University of Edinburgh, and fellow investigators in a research letter in JAMA Oncology.
They note that these findings are in line with a previous trial showing no improvement in general cancer pain with ketamine.
“Future studies that examine ketamine in chronic neuropathic pain should focus on patients with central sensitization, which can be established by a bedside test,” suggest Fallon et al. “This approach would be congruent with preclinical knowledge and would address an important remaining unanswered question.”
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