Fentanyl Buccal Tablet Compared with Immediate-Release Oxycodone for the Management of Breakthrough Pain in Opioid-Tolerant Patients with Chronic Cancer and Noncancer Pain: A Randomized, Double-Blind, Crossover Study Followed by a 12-Week Open-Label Phase to Evaluate Patient Outcomes

Abstract

Fentanyl buccal tablet was associated with rapid onset of analgesia and improvements in functional status and patient satisfaction compared with immediate-release oxycodone.

Transmucosal Immediate-Release Fentanyl for Breakthrough Cancer Pain: Opportunities and Challenges for Use in Palliative Care

“…The PID 15 (mean ± SD) was significantly different with fentanyl buccal tablet (0.88 ± 1.20) compared with oxycodone IR (0.76 ± 1.12). 69 These results are consistent with another study with a larger sample size (n = 188). 70…”

“…69 The patients in the Ashburn et al study preferred fentanyl buccal tablet over oxycodone at 52% and 33%, respectively. 70 No other studies evaluating fentanyl buccal tablet patient preference over other types of pain medication for BTCP were found.…”

Prospective Observational Study of Patient-Controlled Intrathecal Analgesia

“…[24][25][26][27][28][29][30][31][32] For example, a recent study of transmucosal fentanyl achieved a meaningful pain reduction in only 17% of patients within 15 minutes and in 46% within 30 minutes. 33 In contrast to this, in a prospective study of hospice inpatients with BTP, the mean time to onset with appropriately dosed breakthrough medications was 31 minutes. 34 A randomized controlled study by Smith et al 7 evaluated an intrathecal drug delivery system versus comprehensive medical management for the treatment of advanced cancer pain and showed significant improvement in drug toxicities including fatigue and level of consciousness.…”

Assessing age and gender in studies of breakthrough pain medications

“…In four studies oral transmucosal fentanyl citrate (OTFC) was compared with placebo 9 , oral morphine (ORMO) 10 , intravenous morphine (IVMO) 11 , and intranasal fentanyl (INFS) 12 . In four studies, fentanyl buccal tablet (FBT) was compared with placebo 13,14 and oxycodone (OROX) 15,16 . In two studies sublingual fentanyl was compared with placebo 17,18 .…”