Comparison of continuous subcutaneous hydromorphone hydrochloride and morphine hydrochloride injection on skin disorders incidence: a retrospective study.

IF 1.2 Q4 PHARMACOLOGY & PHARMACY Journal of Pharmaceutical Health Care and Sciences Pub Date : 2024-12-19 DOI:10.1186/s40780-024-00401-6
Rei Tanaka, Takahiro Hashizume, Tadashi Hisanaga, Shinya Masuda, Junya Sato, Hiroshi Ishikawa, Hironori Tanaka, Akiyoshi Saitoh, Tetsumi Sato, Takeshi Kamoshida, Tetsu Sato, Michihiro Shino
{"title":"Comparison of continuous subcutaneous hydromorphone hydrochloride and morphine hydrochloride injection on skin disorders incidence: a retrospective study.","authors":"Rei Tanaka, Takahiro Hashizume, Tadashi Hisanaga, Shinya Masuda, Junya Sato, Hiroshi Ishikawa, Hironori Tanaka, Akiyoshi Saitoh, Tetsumi Sato, Takeshi Kamoshida, Tetsu Sato, Michihiro Shino","doi":"10.1186/s40780-024-00401-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Continuous subcutaneous administration of injectable opioids is simple and effective; however, skin disorders may occur when high opioid dosages are used. Therefore, we investigated opioid injection drugs with a low risk of skin disorders.</p><p><strong>Methods: </strong>A retrospective study was conducted using the electronic medical records of patients prescribed 1% hydromorphone hydrochloride or 4% morphine hydrochloride with instructions for continuous subcutaneous administration at Shizuoka Cancer Center from January 2017 to December 2021. The primary endpoint was skin disorders incidence, and the two groups were compared using Cox proportional hazards model analyses and Fisher's exact test at 5% significance level. Patient background factors expected to influence skin disorders were also investigated, and multivariate logistic analysis of skin disorders incidence was performed.</p><p><strong>Results: </strong>The incidence of skin disorders in the hydromorphone hydrochloride and morphine hydrochloride groups were 3.7% (1/27 patients) and 28.1% (9/32 patients), respectively, showing a significant difference in two statistical analyses between the two groups (Cox proportional hazards model analyses HR: 0.09, 95% CI: 0.01-0.70, P = 0.022. Fisher's exact test OR: 0.10, 95% CI: 0.01-0.84, P = 0.016). In the multivariate analysis, the administration of hydromorphone hydrochloride (OR: 0.04, 95% CI: 0.003-0.48, P = 0.012) was also found to have a significant negative correlation with the occurrence of skin disorders. On the contrary, administration period ≥ 28 days (OR: 18.16, 95% CI: 2.22-148.60, P = 0.007) was a factor with a significant positive correlation.</p><p><strong>Conclusions: </strong>Subcutaneous 1% hydromorphone hydrochloride administration had a lower risk of skin disorders than 4% morphine hydrochloride injection. Moreover, prolonging the administration period increased the risk of developing skin disorders. This suggests that a 1% hydromorphone hydrochloride Injection is a good clinical decision for patients who are likely to have a longer administration period and require a higher dosage of injectable opioids.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":16730,"journal":{"name":"Journal of Pharmaceutical Health Care and Sciences","volume":"10 1","pages":"82"},"PeriodicalIF":1.2000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pharmaceutical Health Care and Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s40780-024-00401-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Continuous subcutaneous administration of injectable opioids is simple and effective; however, skin disorders may occur when high opioid dosages are used. Therefore, we investigated opioid injection drugs with a low risk of skin disorders.

Methods: A retrospective study was conducted using the electronic medical records of patients prescribed 1% hydromorphone hydrochloride or 4% morphine hydrochloride with instructions for continuous subcutaneous administration at Shizuoka Cancer Center from January 2017 to December 2021. The primary endpoint was skin disorders incidence, and the two groups were compared using Cox proportional hazards model analyses and Fisher's exact test at 5% significance level. Patient background factors expected to influence skin disorders were also investigated, and multivariate logistic analysis of skin disorders incidence was performed.

Results: The incidence of skin disorders in the hydromorphone hydrochloride and morphine hydrochloride groups were 3.7% (1/27 patients) and 28.1% (9/32 patients), respectively, showing a significant difference in two statistical analyses between the two groups (Cox proportional hazards model analyses HR: 0.09, 95% CI: 0.01-0.70, P = 0.022. Fisher's exact test OR: 0.10, 95% CI: 0.01-0.84, P = 0.016). In the multivariate analysis, the administration of hydromorphone hydrochloride (OR: 0.04, 95% CI: 0.003-0.48, P = 0.012) was also found to have a significant negative correlation with the occurrence of skin disorders. On the contrary, administration period ≥ 28 days (OR: 18.16, 95% CI: 2.22-148.60, P = 0.007) was a factor with a significant positive correlation.

Conclusions: Subcutaneous 1% hydromorphone hydrochloride administration had a lower risk of skin disorders than 4% morphine hydrochloride injection. Moreover, prolonging the administration period increased the risk of developing skin disorders. This suggests that a 1% hydromorphone hydrochloride Injection is a good clinical decision for patients who are likely to have a longer administration period and require a higher dosage of injectable opioids.

Trial registration: Retrospectively registered.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
背景:连续皮下注射阿片类药物既简单又有效,但在使用大剂量阿片类药物时可能会出现皮肤病。因此,我们研究了发生皮肤病风险较低的阿片类注射药物:我们利用静冈癌症中心 2017 年 1 月至 2021 年 12 月期间开具的 1%盐酸氢吗啡酮或 4%盐酸吗啡的患者电子病历进行了一项回顾性研究。主要终点是皮肤病发病率,两组患者的比较采用 Cox 比例危险模型分析和费雪精确检验,显著性水平为 5%。此外,还调查了预计会影响皮肤病的患者背景因素,并对皮肤病发病率进行了多变量逻辑分析:结果:盐酸氢吗啡酮组和盐酸吗啡组的皮肤病发生率分别为 3.7%(1/27 例患者)和 28.1%(9/32 例患者),两组间的两项统计分析结果显示存在显著差异(Cox 比例危险模型分析 HR:0.09,95% CI:0.01-0.70,P = 0.022。费雪精确检验 OR:0.10,95% CI:0.01-0.84,P = 0.016)。在多变量分析中,还发现盐酸氢吗啡酮的用药(OR:0.04,95% CI:0.003-0.48,P = 0.012)与皮肤病的发生呈显著负相关。相反,用药时间≥28 天(OR:18.16,95% CI:2.22-148.60,P = 0.007)与皮肤病的发生呈显著正相关:结论:1%盐酸氢吗啡酮皮下注射比 4%盐酸吗啡注射发生皮肤病的风险更低。此外,延长给药时间会增加出现皮肤病的风险。这表明,1%盐酸氢吗啡酮注射液对于可能需要较长给药时间和需要较大剂量注射阿片类药物的患者来说是一个很好的临床决策:回顾性注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
1.80
自引率
0.00%
发文量
29
审稿时长
8 weeks
期刊最新文献
Comparison of continuous subcutaneous hydromorphone hydrochloride and morphine hydrochloride injection on skin disorders incidence: a retrospective study. Clinical characteristics of patients requiring emergency hospitalization due to immune-related adverse events: a retrospective study. Effect of changes in skin properties due to diabetes mellitus on the titration period of transdermal fentanyl: single-center retrospective study and diabetic animal model study. Pharmacist intervention and identification of adverse events related to treatment efficacy in cancer chemotherapy to improve clinical outcomes. Safety of talimogene laherparepvec: a real-world retrospective pharmacovigilance study based on FDA Adverse Event Reporting System (FAERS).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1