Opioids Remain The Mainstay of Chronic Pain Treatment

May 18, 2011 – Pain is a disabling symptom that can occur at any point in the course of an illness. Since pain considerably affects day to day life, its management offers considerable challenge for physicians. Inadequate pain control remains a major problem across the world. Pain relief medications are dominated by NSAIDs followed by opioids. Long acting opioids are used in the relief of moderate to severe pain which require treatment for several days. Oral Long Acting Opioids (LAOs) are also an option to treat acute pain in non-dependant patients. Opioids are prescribed when pain cannot be adequately controlled with an NSAID.

All NSAIDs/Cox-2 inhibitors have cardiovascular and renal side-effects, and the older NSAIDs have severe gastrointestinal ones too. Therefore in cases of acute and chronic opioids continue to be the mainstay of therapy. However, this market is struggling to generate sales growth against a background of weak pipelines and generic competition.

In 2010, the global opioids market was approximately $11.2 billion, representing a compound annual growth rate (CAGR) of 2.4% between 2002 and 2010. By 2017, the global opioids market is forecast to reach $13.2 billion, indicating a CAGR of 2.8% between 2010 and 2017. The market for pain management drugs is focused on enhancement of available dugs with the development of extended release formulations and drug combinations.

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In an effort to minimize the risk of misuse, abuse, addiction and overdose opioids are made available through a Risk Evaluation and Mitigation Strategy (REMS) program. In order to ensure that the benefits of the drugs outweigh the risks of use in patients, the FDA had notified opioid drug manufacturers to have REMS. Under this program, pharmacies, distributors, and medical care providers who prescribe to outpatients are required to enroll in the program to prescribe, dispense and distribute opioid drugs.

GBI Research, the leading business intelligence provider, has released its latest research,
“Opioids Market to 2017 - Steady Uptake of Oxycontin and High Incidence Of Diseases Such As Cancer And Arthritis to Drive the Market”, which provides insights into global Opioids market and market forecast until 2017.

Report is built using data and information sourced from proprietary databases, primary and secondary research and in-house analysis by GBI Research’s team of industry experts.

The report provides an in-depth analysis of the top five therapeutic indications for which often opioids are prescribed which includes fibromyalgia, neuropathic pain, cancer pain, osteoarthritis pain, rheumatoid arthritis pain, low back pain and post operative pain. The report also examines the global opioids treatment usage patterns for the covered indication. In addition, the report also includes insights into the opioids R&D pipeline
http://www.prlog.org/11496663-opioids-market-to-2017.html

High doses of common painkillers increase stroke risk, warn researchers

British Medical Journal study links ibuprofen to highest risk of stroke over long term

The Guardian,  12 January 2011

Experts looked at 30 clinical trials to examine the effects of painkillers on health. Photograph: Nitschkefoto / Alamy/Alamy

Commonly used painkillers increase the risk of heart attacks and strokes when taken at high doses or over the long term, according to research.

Experts analysed more than 30 clinical trials on more than 116,000 patients to examine the effects of painkillers on people's health.

The fears relate to non-steroidal anti-inflammatory drugs as well as newer anti-inflammatory drugs known as Cox-2 inhibitors.

Doctors regularly prescribe such drugs to treat painful conditions, including osteoarthritis.

They are given at much higher doses than those found in over-the-counter remedies, which are used for occasional headaches, aches and pains.

The study, in the British Medical Journal, found that compared with a dummy drug lumiracoxib increased the risk of heart attacks, while ibuprofen was linked to the highest risk of stroke (more than treble the risk).

Diclofenac almost tripled the risk, while etoricoxib and diclofenac were associated with around a fourfold increased risk of suffering death from cardiovascular causes.

The authors, from the University of Bern in Switzerland, said: "Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms."

In an accompanying editorial, Prof Wayne Ray, from the department of preventive medicine in Nashville, said: "Naproxen seemed least harmful.

"Cardiovascular risk needs to be taken into account when prescribing any non-steroidal anti-inflammatory drug."

Overall, the number of heart attacks and strokes reported was low compared to the number of patients.

In 29 of the trials, there were a total of 554 heart attacks and in 26 trials there were 377 strokes. In 28 trials there were 676 deaths.

http://www.guardian.co.uk/science/2011/jan/12/high-doses-painkillers-stroke-risk