Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease

  • Review
  • Intervention

Authors


Abstract

Background

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is the most common neurodegenerative disorder of the motor system in adults. Pain in ALS is a frequent symptom especially in the later stages of disease and can have a pronounced influence on quality of life and suffering. Treatment of pain therefore should be recognised as an important aspect of palliative care in ALS.

Objectives

To systematically review the evidence for the efficacy of drug therapy in relieving pain in ALS. We also aimed to evaluate possible adverse effects associated with the different drugs and their influence on survival and quality of life.

Search methods

We searched the following databases: the Cochrane Neuromuscular Disease Group Specialised Register (18 May 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (2010, Issue 2 in The Cochrane Library), MEDLINE (January 1966 to May 2010), EMBASE (January 1980 to May 2010), CINAHL (January 1982 to May 2010), AMED (January 1985 to May 2010) and LILACS (January 1982 to May 2010). We checked the bibliographies of trials identified and contacted other disease experts to identify further published and unpublished trials.

Selection criteria

We searched for randomised or quasi-randomised controlled trials on drug therapy for pain in amyotrophic lateral sclerosis.

Data collection and analysis

We collected data using a specially designed form and analysed them using the Cochrane Review Manager software.

Main results

We found no randomised or quasi-randomised controlled trials on drug therapy for pain in ALS or MND.

Authors' conclusions

There is no evidence from randomised controlled trials about the management of pain in ALS. Further research on this important aspect of palliative care in ALS is needed. Randomised controlled trials should be initiated to determine the effectiveness of different analgesics for treatment of pain in ALS.

摘要

背景

針對運動神經元疾病(motor neuron disease)暨肌萎縮性脊髓側索硬化症(amyotrophic lateral sclerosis)疼痛方面的藥物治療

肌萎縮性脊髓側索硬化症,即運動神經元疾病,是成人運動系統最常見的神經退化性疾病。疼痛是疾病晚期常見的症狀,影響生活品質甚鉅。故疼痛處理在肌萎縮性脊髓側索硬化症緩和療法中具有重要意義。

目標

予以系統性回顧緩解疼痛之藥物效用。並且評估不同藥物之可能副作用暨對於生活品質和生存的影響。

搜尋策略

搜尋以下資料庫: the Cochrane Neuromuscular Disease Group Trials Register (2007年10月), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007年, Issue 1), MEDLINE (1966年1月至2007年10月), EMBASE (1980年1月至2007年10月), CINAHL (1982年1月至2007年10月), AMED (1985年1月至2007年10月) and LILACS (1982年1月至2007年10月). 我們並確認參考文獻及聯絡其他疾病的專家們以確認其餘試驗資料

選擇標準

我們搜尋關於藥物治療肌萎縮性脊髓側索硬化症之疼痛的隨機或半隨機對照實驗

資料收集與分析

以特別設計的表格收集資料並且以 Cochrane Review Manager程式分析資料

主要結論

沒有找到關於藥物治療肌萎縮性脊髓側索硬化症之疼痛的隨機或半隨機對照實驗

作者結論

沒有從隨機對照實驗找到任何證據關於藥物治療肌萎縮性脊髓側索硬化症之疼痛。必須做更進一步關於肌萎縮性脊髓側索硬化症緩和照顧的研究。應嘗試探討關於不同止痛藥物對於肌萎縮性脊髓側索硬化症疼痛之療效的隨機對照實驗。

翻譯人

本摘要由新光醫院彭馨婷翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

肌萎縮性脊髓側索硬化症,即運動神經元疾病,是成人運動系統最常見的神經退化性疾病。疼痛是疾病晚期常見的症狀,影響生活品質甚鉅。然而搜尋許多資料庫後,並沒有發現相關藥物療法的隨機對照實驗。故現今並無證據顯示何種療法較佳。

Plain language summary

Drug therapy for pain in amyotrophic lateral sclerosis or motor neuron disease

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is the most common neurodegenerative disorder of the motor system in adults. Pain is a frequent symptom and may have a pronounced impact on quality of life and suffering. Despite an extensive search of different medical databases, this review was not able to identify any randomised controlled trials on drug therapy for pain in ALS. Currently no evidence exists for using one type of treatment over another.