Palliative Care Research Projects
Palliative Care Research Projects
Completed projects
MENAC
The MENAC (Multimodal-Exercise, Nutrition and Anti-inflammatory medication for Cachexia) trials goal is to establish whether a multimodal intervention is effective in treating cachexia.
Cancer cachexia is a multifactorial syndrome characterized by an ongoing loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support alone. Cachexia has a high prevalence in cancer and a major impact on patient physical function, morbidity and mortality.
Despite the consequences of cachexia, there is no licensed treatment for cachexia and no accepted standard of care. It has been argued that the multifactorial genesis of cachexia lends itself to therapeutic targeting through a multimodal treatment approach. Following a successful phase II trial, a phase III randomized controlled trial was initiated. The MENAC intervention is based on evidence to date and consists of non-steroidal anti-inflammatory drugs and eicosapentaenoic acid to reduce inflammation, a physical exercise program using resistance and aerobic training to increase anabolism, combined with dietary counselling and oral nutritional supplements to promote energy and protein balance.
ParaStop
ParaStop (Paracetamol with Strong Opioids) is a prospective international multi-center parallel group, randomized, placebo-controlled, double-blinded non-inferiority withdrawal trial of placebo versus paracetamol in patients using strong opioids for cancer pain.
The prescribing of paracetamol in conjunction with strong opioids for patients with cancer pain is common practice in most countries worldwide and still recommended by the WHO. There is a need to establish high quality evidence on whether paracetamol provides additional analgesic effect in cancer pain patients receiving strong opioids.
The primary study objective is to establish whether the analgesic efficacy of strong opioids is non-inferior after withdrawal of paracetamol compared to the analgesic efficacy of strong opioids and paracetamol for cancer-related pain.
Eligible patients have metastatic cancer with a life expectancy of more than 2 months; using both strong opioids and 1 gram of paracetamol 3-4 times daily. When entering the trial at baseline, Day 1, they will be randomized to receive either paracetamol or placebo for seven days in addition to their usual opioid doses. The study team will provide paracetamol or placebo tablets from day 1 of study. After a week, the participants will come to the last study visit (day 8). A follow-up phone call will be conducted 3-7 days after the day 8 visit.