羟考酮治疗癌痛的有效性和安全性研究:一项多中心、前瞻性药学监护队列研究

注册号:

Registration number:

ChiCTR2500114811 

最近更新日期:

Date of Last Refreshed on:

2025-12-17 17:57:05 

注册时间:

Date of Registration:

2025-12-17 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

羟考酮治疗癌痛的有效性和安全性研究:一项多中心、前瞻性药学监护队列研究

Public title:

A Multicenter, Prospective Pharmacist Care Cohort Study on the Efficacy and Safety of Oxycodone in Treating Cancer Pain

注册题目简写:

English Acronym:

研究课题的正式科学名称:

羟考酮治疗癌痛的有效性和安全性研究:一项多中心、前瞻性药学监护队列研究

Scientific title:

A Multicenter, Prospective Pharmacist Care Cohort Study on the Efficacy and Safety of Oxycodone in Treating Cancer Pain

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李新燕 

研究负责人:

李语玲 

Applicant:

Xinyan Li 

Study leader:

Yuling Li 

申请注册联系人电话:

Applicant telephone:

+86 131 2055 1883

研究负责人电话:

Study leader's
telephone:

+86 136 7185 7685

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

lixinyan05@126.com

研究负责人电子邮件:

Study leader's E-mail:

yuling19893@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

上海市普陀区兰溪路164号

研究负责人通讯地址:

上海市普陀区兰溪路164号

Applicant address:

No. 164 Lanxi Road, Putuo District, Shanghai

Study leader's address:

No. 164 Lanxi Road, Putuo District, Shanghai

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

上海市普陀区中心医院

Applicant's institution:

Putuo District Central Hospital, Shanghai

研究负责人所在单位:

上海市普陀区中心医院

Affiliation of the Leader:

Putuo District Central Hospital, Shanghai

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

PTEC-A-2025-52-1

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

上海市普陀区中心医院(上海中医药大学附属普陀医院)伦理委员会

Name of the ethic committee:

Ethics Committee of Putuo District Center Hospital.Shanghai(Putuo Hospital,Shanghai University of Traditional Chinese Medicine)

伦理委员会批准日期:

Date of approved by ethic committee:

2025-11-07 00:00:00

伦理委员会联系人:

潘姗姗

Contact Name of the ethic committee:

Shanshan Pan

伦理委员会联系地址:

上海市普陀区兰溪路164号

Contact Address of the ethic committee:

No. 164 Lanxi Road, Putuo District, Shanghai

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 2223 4110

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

上海市普陀区中心医院

Primary sponsor:

Putuo District Central Hospital,Shanghai

研究实施负责(组长)单位地址:

上海市普陀区兰溪路164号

Primary sponsor's address:

No. 164 Lanxi Road, Putuo District, Shanghai

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海

市(区县):

普陀

Country:

China

Province:

Shanghai

City:

Putuo

单位(医院):

上海市普陀区中心医院

具体地址:

上海市普陀区兰溪路164号

Institution
hospital:

Putuo District Central Hospital,Shanghai

Address:

No. 164 Lanxi Road, Putuo District, Shanghai

经费或物资来源:

吴阶平医学基金会科研专项资助基金

Source(s) of funding:

WU JIEPING MEDICAL FOUNDATION

研究疾病:

癌痛  

Target disease:

Cancer pain

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究旨在通过前瞻性药学监护队列研究,系统评估羟考酮在癌痛患者中的治疗窗、有效性及安全性,并深入探讨药物转运体基因(ABCB1)和代谢酶基因(CYP3A4/5和CYP2D6)多态性对羟考酮药代动力学、药效学的影响。研究将结合羟考酮的血药浓度监测,分析代谢浓度与药效关系,同时考察年龄、肝肾功能、合并用药等临床影响因素。通过建立基于基因型-代谢表型-血药浓度-临床疗效/安全性的多维度预测模型,为癌痛患者提供精准的羟考酮个体化用药方案,在优化镇痛效果的同时,最大限度降低不良反应和成瘾风险。  

Objectives of Study:

This study aims to systematically evaluate the therapeutic window, efficacy, and safety of oxycodone in cancer pain patients through a prospective pharmaceutical care cohort study. It will also explore in depth the impact of polymorphisms in drug transporter genes (ABCB1) and metabolic enzyme genes (CYP3A4/5 and CYP2D6) on the pharmacokinetics and pharmacodynamics of oxycodone. The research will integrate blood concentration monitoring of oxycodone to analyze the relationship between metabolic concentration and pharmacological effects, while also examining clinical influencing factors such as age, liver and kidney function, and concomitant medications. By establishing a multidimensional prediction model based on genotype, metabolic phenotype, blood concentration, and clinical efficacy/safety, the study aims to provide personalized oxycodone treatment plans for cancer pain patients. This approach seeks to optimize analgesic effects while minimizing adverse reactions and addiction risks.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.非癌性疼痛; 2.阿片耐受; 3.绝对中性粒细胞计数<1.5×10^9/L,血小板<100×10^9/L,血红蛋白<80 g/L; 4.血清总胆红素≥1.5×ULN,天门冬氨酸(aspartate aminotransferase,AST)和丙氨酸氨基转移酶(alanine aminotransferase,ALT)≥2.5×ULN,或肝转移患者的 AST≥1.5×ULN、ALT≥1.5×ULN; 5.严重肾功能不全(eGFR<30 mL/min); 6.羟考酮禁忌症(如严重呼吸抑制、药物滥用史、胃肠道梗阻); 7.无法配合随访或数据收集(如认知障碍、语言障碍); 8.既往接受过基因检测指导阿片用药(避免混杂因素); 9.孕期妇女。

Exclusion criteria:

1. Non-cancer-related pain; 2. Opioid tolerance; 3. Absolute neutrophil count < 1.5×10⁹/L, platelets < 100×10⁹/L, hemoglobin < 80 g/L; 4. Serum total bilirubin >= 1.5×ULN, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) >= 2.5×ULN, or AST >= 1.5×ULN and ALT >= 1.5×ULN in patients with liver metastases; 5. Severe renal insufficiency (eGFR < 30 mL/min); 6. Contraindications to oxycodone (e.g., severe respiratory depression, history of drug abuse, gastrointestinal obstruction); 7. Inability to cooperate with follow-up or data collection (e.g., cognitive impairment, language barrier); 8. Prior use of genetic testing to guide opioid therapy (to avoid confounding factors); 9. Pregnant women.

研究实施时间:

Study execute time:

From 2025-12-01 00:00:00 To 2027-08-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-12-29 00:00:00 To 2027-08-31 00:00:00

干预措施:

Interventions:

组别:

基因位点检测

样本量:

100

Group:

Genetic Locus Testing

Sample size:

干预措施:

干预措施代码:

Intervention:

NO

Intervention code:

组别:

实验组

样本量:

105

Group:

Experimental Group

Sample size:

干预措施:

待完成前100例患者的关联性分析并得出初步结果后,研究中后期将根据初始分析得到的基因型分级结果,对实验组后续患者实施个体化治疗。

干预措施代码:

Intervention:

After the correlation analysis of the first 100 patients is completed and preliminary results are obtained, individualized treatment will be implemented for subsequent patients in the experimental group during the mid-to-late stages of the study, based on the genotype stratification results derived from the initial analysis.

Intervention code:

组别:

对照组

样本量:

105

Group:

Control Group

Sample size:

干预措施:

对照组则接受常规羟考酮治疗,按临床指南或医生/药师经验调整剂量,不参考基因型。

干预措施代码:

Intervention:

The control group received standard oxycodone treatment, with doses adjusted according to clinical guidelines or the experience of doctors/pharmacists, without reference to genotype.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市第一人民医院 

单位级别:

三甲 

Institution
hospital:

Shanghai First People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市东方医院 

单位级别:

三甲 

Institution
hospital:

Shanghai East Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海市普陀区中心医院 

单位级别:

三级 

Institution
hospital:

Putuo District Central Hospital, Shanghai

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

基因型

指标类型:

主要指标

Outcome:

Genotype

Type:

Primary indicator

测量时间点:

测量方法:

荧光定量PCR分析法

Measure time point of outcome:

Measure method:

Real-time Fluorescent Quantitative PCR Analysis

指标中文名:

NRS疼痛评分

指标类型:

主要指标

Outcome:

NRS Pain Score

Type:

Primary indicator

测量时间点:

测量方法:

疼痛数字评分量表评分

Measure time point of outcome:

Measure method:

Pain Numerical Rating Scale Score

指标中文名:

血清疼痛介质水平

指标类型:

主要指标

Outcome:

Serum Pain Mediator Levels

Type:

Primary indicator

测量时间点:

测量方法:

检测血清疼痛介质水平

Measure time point of outcome:

Measure method:

Measurement of Serum Pain Mediator Levels

指标中文名:

睡眠质量

指标类型:

主要指标

Outcome:

Sleep Quality

Type:

Primary indicator

测量时间点:

测量方法:

匹兹堡睡眠质量指数评分

Measure time point of outcome:

Measure method:

Pittsburgh Sleep Quality Index Score

指标中文名:

生活质量

指标类型:

主要指标

Outcome:

Quality of Life

Type:

Primary indicator

测量时间点:

测量方法:

世卫组织生活简易量表评分

Measure time point of outcome:

Measure method:

World Health Organization Quality of Life-BREF Score (WHOQOL-BREF Score)

指标中文名:

焦虑程度

指标类型:

主要指标

Outcome:

Anxiety Level

Type:

Primary indicator

测量时间点:

测量方法:

汉密尔顿焦虑量表评分

Measure time point of outcome:

Measure method:

Hamilton Anxiety Rating Scale Score

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后保存  

说明

2年

Fate of sample:

Preservation after use  

Note:

Two years

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 90 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

用SPSS软件产生分层随机数表,产生相应随机编号,根据患者临床就诊顺序由研究者到统计人员处领取相应随机编号开展研究。

Randomization Procedure (please state who generates the random number sequence and by what method):

A stratified randomization table was generated using SPSS software to produce corresponding random numbers. Based on the patients' clinical visit order, the researchers obtained the corresponding random numbers from the statistician to conduct the study.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

本研究为开放标签设计,受试者及研究干预实施者均知晓治疗分组。为减少测量偏倚,主要结局指标(疼痛NRS评分)的评估将尽可能标准化,并由经过统一培训的研究人员收集。所有数据的统计分析将由不知晓分组信息的独立统计学家在盲态下完成

Blinding:

This study employs an open‑label design. Both subjects and the intervention administrators are aware of the treatment group assignment. To minimize measurement bias, the assessment of the primary outcome (Pain Numerical Rating Scale score) will be standardized as much as possible and conducted by uniformly trained research staff. All statistical analyses will be performed independently by a statistician who is blinded to group allocation.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

2028年1月(www.medresman.org.cn)

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

2028.01(www.medresman.org.cn)

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form, CRF

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-12-17 17:56:47