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Intrathecal therapy: what has changed with the introduction of ziconotide.
Pain Pract. 2009 Sep-Oct; 9(5):338-47.PP

Abstract

Administering drugs into the intrathecal space is becoming more popular in the treatment of patients with intractable pain or intolerable side effects of systemic analgesic treatments. Although morphine and ziconotide are the only intrathecal analgesics currently approved by regulatory authorities in the U.S. (Food and Drug Administration) and Europe (national-level approval by individual countries for morphine and European Agency for the Evaluation of Medicinal Products approval for ziconotide), a wide variety of opioid and non-opioid drugs are being used in this way. There is no official guidance concerning the selection of these drugs or their use in combinations and a paucity of efficacy and safety data from randomized controlled trials. The polyanalgesic initiative aims to summarize the current knowledge and to facilitate rational choices of intrathecal drug and drug combinations for the management of chronic pain. The most recent polyanalgesic consensus recommendations were published in 2007. In this review, we shall examine these recommendations, which are tailored toward those practicing intrathecal analgesia in the U.S., and discuss how they should be implemented in Europe, where the healthcare systems and regulations of the medical authorities are different.

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Authors+Show Affiliations

Kress HG
Medical University of Vienna, A-1090 Vienna, Austria. hans-georg.kress@meduniwien.ac.at
Simpson KH
No affiliation info available
Marchettini P
No affiliation info available
Ver Donck A
No affiliation info available
Varrassi G
No affiliation info available

MeSH

Analgesics, Non-NarcoticHumansInjections, SpinalPainomega-Conotoxins

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19740270

Citation

Kress, Hans G., et al. "Intrathecal Therapy: what Has Changed With the Introduction of Ziconotide." Pain Practice : the Official Journal of World Institute of Pain, vol. 9, no. 5, 2009, pp. 338-47.
Kress HG, Simpson KH, Marchettini P, et al. Intrathecal therapy: what has changed with the introduction of ziconotide. Pain Pract. 2009;9(5):338-47.
Kress, H. G., Simpson, K. H., Marchettini, P., Ver Donck, A., & Varrassi, G. (2009). Intrathecal therapy: what has changed with the introduction of ziconotide. Pain Practice : the Official Journal of World Institute of Pain, 9(5), 338-47. https://doi.org/10.1111/j.1533-2500.2009.00308.x
Kress HG, et al. Intrathecal Therapy: what Has Changed With the Introduction of Ziconotide. Pain Pract. 2009 Sep-Oct;9(5):338-47. PubMed PMID: 19740270.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrathecal therapy: what has changed with the introduction of ziconotide. AU - Kress,Hans G, AU - Simpson,Karen H, AU - Marchettini,Paolo, AU - Ver Donck,Ann, AU - Varrassi,Giustino, PY - 2009/9/11/entrez PY - 2009/9/11/pubmed PY - 2009/12/16/medline SP - 338 EP - 47 JF - Pain practice : the official journal of World Institute of Pain JO - Pain Pract VL - 9 IS - 5 N2 - Administering drugs into the intrathecal space is becoming more popular in the treatment of patients with intractable pain or intolerable side effects of systemic analgesic treatments. Although morphine and ziconotide are the only intrathecal analgesics currently approved by regulatory authorities in the U.S. (Food and Drug Administration) and Europe (national-level approval by individual countries for morphine and European Agency for the Evaluation of Medicinal Products approval for ziconotide), a wide variety of opioid and non-opioid drugs are being used in this way. There is no official guidance concerning the selection of these drugs or their use in combinations and a paucity of efficacy and safety data from randomized controlled trials. The polyanalgesic initiative aims to summarize the current knowledge and to facilitate rational choices of intrathecal drug and drug combinations for the management of chronic pain. The most recent polyanalgesic consensus recommendations were published in 2007. In this review, we shall examine these recommendations, which are tailored toward those practicing intrathecal analgesia in the U.S., and discuss how they should be implemented in Europe, where the healthcare systems and regulations of the medical authorities are different. SN - 1533-2500 UR - https://www.unboundmedicine.com/medline/citation/19740270/Intrathecal_therapy:_what_has_changed_with_the_introduction_of_ziconotide_ L2 - https://doi.org/10.1111/j.1533-2500.2009.00308.x DB - PRIME DP - Unbound Medicine ER -