Fentanyl buccal tablet for breakthrough cancer pain in clinical practice: results of the non-interventional prospective study ErkentNIS

Masel, Eva Katharina; Landthaler, R.; Gneist, Margit; Watzke, Herbert

doi:10.1007/s00520-017-3853-y

Cited by 6 publications

(4 citation statements)

References 31 publications

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“…These studies indicated that buccal fentanyl is well tolerated and may improve patient functioning, mood, and overall satisfaction in the management of breakthrough cancer pain. [37][38][39][40] The addition of intrathecal fentanyl to spinal anaesthesia decreases opioid consumption during the period of highest analgesic demand after caesarean section. 41 The transpulmonary fentanyl route remains an experimental phase for the management ofacute or chronic pain.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Fentanyl Compared With Morphine among Adult Patients with Cancer: A Meta-Analysis

Manirakiza¹,

Irakoze

Manirakiza

et al. 2020

EAHRJ

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Background: Cancer pain is experienced by numerous patients; thus, the main pain-relieving opioid analgesics, fentanyl and morphine, are of great importance. However, their analgesic efficacy and safety are different among individuals and are still controversial. The aim of this study was to compare the safety and efficacy of fentanyl and morphine among patients with cancer. Methods: We performed a meta-analysis by searching PubMed and the Cochrane Library up to 01 April 2019. The search terms were fentanyl, morphine, opioids and cancer pain. All randomised controlled trials comparing fentanyl and morphine were included in the analysis. Results: Overall, the initial search identified 2970 published studies; among them, 9 studies were included in the efficacy analysis and 8 studies were included in the safety analysis. The oral morphine versus oral transmucosal fentanyl subgroup analysis showed a mean difference(MD)=0.47[Confidence interval(CI):0.35-0.58] with an overall effect, Z=8.10, P<.00001. The outcome of the oral morphine versus nasal/transdermal fentanyl subgroup indicated a MD=0.20[CI:0.3-0.37] with an overall effect, Z=2.24 and P=.02. For the oral morphine versus buccal/sublingual fentanyl subgroup, the analysis revealed a MD=1.80[CI:1.35-2.25] with an overall effect, Z=7.87 and P<.00001. The oral morphine versus other forms of fentanyl subgroup showed a MD=0.70[95%CI:0.34-1.06] with the test for the overall effect, Z=3.81 and P=.0001. Constipation, drowsiness, confusion and dry mouth were more common in the morphine group than in the fentanyl group, with a risk ratio=0.60[

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Fentanyl Compared With Morphine among Adult Patients with Cancer: A Meta-Analysis

Manirakiza¹,

Irakoze

Manirakiza

et al. 2020

EAHRJ

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“…Masel et al 35 Document the feasibility of fentanyl oral tablets for the treatment of patients with transitory exacerbation cancer pain.…”

Section: Discussionmentioning

confidence: 99%

“…The action time of each patch is 72 hours, remaining for 12 to 18 hours after its removal. The transmucosal formulation has short action duration, non-invasive administration route, and tolerable safety profile 14,17,25,26,34,35 .…”

Section: Fentanylmentioning

confidence: 99%

The use of opioids in the treatment of oncologic pain in the elderly

Silva

Mendanha

Gomes

2020

Brazilian Journal of Pain

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BACKGROUND AND OBJECTIVES: The use of opioids in cancer is already widespread and proven by several well-controlled clinical trials. However, the elderly with cancer pain are undertreated due to the lack of knowledge in the management of these patients, the underestimation of pain, as well as the fear of complications arising in this age group. Therefore, the scientific community contributes to giving inputs to create possible clinical and health guidelines. The present study aimed to perform a systematic literature review of opioid treatments proposed for cancer-related pain in elderly patients. CONTENTS: The search on the literature included papers addressing cancer pain treatment with opioids among the elderly, published from 2008 to 2018, and available in Portuguese or English. Searches were conducted on Medical Literature, Analysis, and Retrieval System Online (MEDLINE) and Latin American and Caribbean Health Sciences Literature (LILACS) electronic databases using the keywords "cancer pain", "opioids", and "elderly" in both languages, combined with the Boolean operator "AND". To analyze the quality of the method, the adapted Critical Appraisal Skills Programme was used. Of a total of 411 studies found, 32 were included. About 75% of the selected articles were published in the last five years. CONCLUSION: The results showed that opioids remain the pillar to treat cancer-related pain in the elderly. They can be used for better management of pain, but with caution due to the possible adverse effects. In addition, pain management in the elderly requires a multifactorial analysis, including comorbidities, polypharmacy, and patient functionality. Therefore, an individualized approach in the elderly patient is required in order to enhance results, reduce side effects, and improve quality of life.

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“…In a meta-analysis by Zeppetella et al, the difference in pain intensity control compared with placebo 15 min after intake was greater with all formulations of fentany than with other BTcP medications (20). Moreover, a reduction in the number of BTcP episodes was documented and patient satisfaction was rated as excellent or good (21,22). Patient satisfaction was also rated as high with fentanyl pectin nasal spray (23).…”

Section: Roos For Treatment Of Btcpmentioning

confidence: 99%

Rapid-Onset Opioids for Management of Breakthrough Cancer Pain: Considerations for Daily Practice

2022

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Background and ObjectiveRapid-onset opioids (ROOs) are effective treatments for breakthrough cancer pain (BTcP) given their rapid onset of action and relatively short duration of analgesia. The aim of this article is to describe specific considerations for the use of ROOs in daily practice, focusing on dose titration and treatment of specific populations.Type of ReviewWe conducted a narrative review on the use of ROOs for BTcP. We selected papers according to the following search terms: “breakthrough cancer pain” and “rapid onset opioids”.ResultsROOs may be considered as the most suitable drugs to treat BTcP and can be used “on-demand”. Several fentanyl formulations are available and have been associated with control of BTcP and with improvement in quality of life. Various titration schemes have been used to optimize ROO dosing; however, a dose-proportional scheme could be considered safe and effective in most patients. Specific formulations may be more suitable for specific patient subgroups; for example, patients with oral mucositis may prefer intranasal to oral formulations. Moreover, elderly patients or those without caregivers should be clearly educated on the use of these formulations. A key element in achieving successful treatment of BTcP is awareness of the barriers to pain management, including poor overall assessment, patient reluctance to take opioids or report pain, and physician reluctance to prescribe opioids.ConclusionA personalized approach is fundamental when prescribing a medication for BTcP, and careful attention should be given to drug choice and route of administration, and to the need for alternative therapeutic options.

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Fentanyl buccal tablet for breakthrough cancer pain in clinical practice: results of the non-interventional prospective study ErkentNIS

Cited by 6 publications

References 31 publications

Efficacy and Safety of Fentanyl Compared With Morphine among Adult Patients with Cancer: A Meta-Analysis

Efficacy and Safety of Fentanyl Compared With Morphine among Adult Patients with Cancer: A Meta-Analysis

The use of opioids in the treatment of oncologic pain in the elderly

Rapid-Onset Opioids for Management of Breakthrough Cancer Pain: Considerations for Daily Practice

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