Pain and symptom severity outcomes in patients with cancer before and after intrathecal drug delivery: mixed model analysis in 222 cases
Authors' conclusion
Among patients with advanced cancer, pain and symptom burden worsened prior to IDD but improved within 90 days after implantation, with sustained benefits observed up to 1 year.
Study context
- Population
- Patients with cancer pain treated with intrathecal drug delivery (IDD) at an academic cancer center, 2013–2023of 435 screened
- Participants
- 222 patients
- Exposure
- Pain and symptom scores before vs after IDD initiation
- Outcome
- Changes in BPI-SEV, BPI-INT and CMSAS-PHYS after IDD
- Follow-up
- First 90 days after implantation
Methodological detailssingle-centre, joint longitudinal-survival models
- Single-centre
- Joint longitudinal-survival models
Main finding
As reported in the abstract
BPI-Severity (BPI-SEV) decreased, units/day
0.014
n=219; 95% CI −0.020 to −0.009; p<0.001
BPI-Interference (BPI-INT) decreased, units/day
0.020
n=209; 95% CI −0.029 to −0.011; p<0.001
CMSAS-Physical (CMSAS-PHYS) improved, units/day
0.004
n=195; 95% CI −0.006 to −0.001; p=0.002
Observational data: associations, not effects.
Secondary outcomes
Systemic opioid discontinuation · during follow-up
- Discontinued systemic opioids
- 91%
Symptom trajectories
- Worsened prior to implantation and improved following IDD initiation
Mean composite scores (BPI-SEV, BPI-INT, CMSAS-PHYS) · up to 1 year
- Improved significantly across all time points
Original publication
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