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Table 2 Efficacy and safety parameters according to COMT rs4680 polymorphism in the 87 subjects included in the STOP Pain Project

From: Opioid response in paediatric cancer patients and the Val158Met polymorphism of the human catechol-O-methyltransferase (COMT) gene: an Italian study on 87 cancer children and a systematic review

 

Overall

G/G

A/G

A/A

p-value

Opioids

 Dose (mg/kg)

  Dose24h

   mean (95% CI)

0.38 (0.33–0.42)

0.41 (0.30–0.52)

0.39 (0.33–0.45)

0.36 (0.23–0.48)

 

   median (interquartile range)

0.41 (0.19–0.50)

0.43 (0.16–0.57)

0.42 (0.24–0.49)

0.43 (0.19–0.46)

0.921*

  Dosetot

   mean (95% CI)

2.57 (2.17–2.96)

3.34 (2.45–4.23)

2.35 (1.83–2.87)

2.24 (1.11–3.37)

 

   median (interquartile range)

2.18 (1.20–3.50)

3.25 (1.73–5.23)

2.02 (1.26–2.97)

2.18 (1.06–3.07)

0.119*

  DoseVAS = 0

   mean (95% CI)

0.41 (0.27–0.55)

0.59 (0.18–1.01)

0.35 (0.22–0.48)

0.39 (0.03–0.75)

 

   median (interquartile range)

0.26 (0.10–0.49)

0.36 (0.07–0.74)

0.21 (0.11–0.47)

0.25 (0.10–0.41)

0.568*

Pain Intensity

 ∆ VAS, N (%)

   ≤ 2

46 (54.12)

15 (62.50)

20 (50.00)

6 (46.15)

0.533**

   ≥ 2

39 (45.88)

9 (37.50)

20 (50.00)

7 (53.85)

 Time tot (hours)

     

  mean (95% CI)

140.43 (126.81–154.05)

166.87 (143.42–190.33)

133.67 (111.87–155.46)

116.61 (87.64–145.59)

0.042***

  median (interquartile range)

133.00 (99.00–192.00)

190.50 (139.25–199.00)

130.00 (96.00–185.50)

120.00 (76.00–144.00)

 

Side effects, N (%)a

 Gastrointestinalb

23 (26.44)

8 (33.33)

9 (21.43)

3 (23.08)

0.553**

 CNSc

10 (11.49)

2 (8.33)

4 (9.52)

2 (15.38)

0.780**

 Totald

32 (36.78)

10 (41.67)

14 (33.33)

4 (30.77)

0.736**

Morphine

 Dose (mg/kg)

  Dose24h

   mean (95% CI)

0.49 (0.45–0.53)

0.55 (0.44–0.66)

0.47 (0.41–0.52)

0.49 (0.38–0.60)

 

   median (interquartile range)

0.46 (0.41–0.57)

0.50 (0.43–0.65)

0.46 (0.40–0.55)

0.46 (0.43–0.60)

0.170*

  Dosetot

   mean (95% CI)

3.19 (2.72–3.67)

4.39 (3.49–5.30)

2.75 (2.14–3.35)

3.04 (1.48–4.60)

 

   median (interquartile range)

2.93 (1.82–4.42)

4.52 (3.25)

2.23 (1.72–3.40)

2.98 (1.70–3.33)

0.050*

  DoseVAS = 0

   mean (95% CI)

0.54 (0.35–0.74)

0.88 (0.28–1.49)

0.41 (0.25–0.56)

0.56 (0.00–1.16)

 

   median (interquartile range)

0.36 (0.17–0.60)

0.54 (0.36–0.96)

0.26 (0.14–0.52)

0.37 (0.20–0.48)

0.257*

Pain Intensity

 ∆ VAS, N (%)

   ≤ 2

29 (49.15)

10 (62.50)

16 (51.61)

2 (25.00)

0.221**

   ≥ 2

30 (50.85)

6 (37.50)

15 (48.39)

6 (75.00)

 Time tot (hours)

  mean (95% CI)

147.96 (131.56–164.36)

174.62 (149.82–199.43)

139.53 (113.56–165.50)

134.00 (96.72–171.28)

0.154***

  median (interquartile range)

142.50 (101.50–193.50)

190.50 (150.00–199.00)

130.25 (100.5–188.75)

123.50 (99.50–173.25)

 

Side effects, N (%)a

 Gastrointestinalb

14 (23.33)

5 (31.25)

6 (18.75)

2 (25.00)

0.621**

 CNSc

6 (10.00)

1 (6.25)

2 (6.25)

1 (12.50)

0.817**

 Totald

19 (31.67)

6 (37.57)

9 (28.13)

2 (25.00)

0.752**

  1. Opioids: morphine equivalents (patients that used more than one opioid)
  2. Morphine: patients that used only morphine
  3. Dose24h: total dose (mg/kg) of intravenous (IV) morphine equivalents (ME) administered during the titration phase; Dosetot: total dose (mg/kg) of IV ME; DoseVAS = 0: mean dose (mg/kg) required to achieve total pain relief
  4. PIto: pain intensity before treatment, measured with FLACC (Face, Legs, Activity, Cry, Consolability) or VAS (Visual Analogic Scale) numeric scale or WONG & BAKER Pain Rating Scale (range: 0–10); ∆ VAS: difference between the pain intensity after 24 h of treatment and PIto; Time tot: time in hours to reach the lowest pain intensity possible
  5. a N, number of patients who experienced that ADR; each patient could have experienced more than one ADRs
  6. b Gastrointestinal effects included nausea/vomiting, diarrhea, and constipation
  7. c CNS: Central Nervous System effects included agitation, drowsiness, headache, and sedation
  8. d Total number of patients with gastrointestinal and/or central nervous system effects, and/or itching
  9. * p-value from Pearson chi-squared test of the equality of the medians
  10. ** p-value form ANOVA
  11. *** p-value from chi-squared test