<p>Tapentadol for neuropathic pain: a review of clinical studies</p>

Abstract

Neuropathic pain (NP) is an enormous burden for patients, caregivers and society. NP is a pain state that may develop after injury of the peripheral or central nervous system because of a wide range of diseases and traumas. A NP symptom component can be found also in several types of chronic pain. Many NP patients are substantially disabled for years. Due to its chronicity, severity and unpredictability, NP is difficult to treat. Tapentadol is a central-acting oral analgesic with combined opioid and noradrenergic properties, which make it potentially suitable for a wide range of pain conditions, particularly whenever a NP component is present or cannot be excluded. In randomized controlled trials, tapentadol has proved to be effective in relieving NP in diabetic peripheral neuropathy and in chronic low back pain. In observational studies, tapentadol reduced NP in chemotherapy-induced peripheral neuropathies, blood and solid cancers, and the NP component in neck pain and Parkinson’s disease. This narrative review aims to provide clinicians with a broad overview of tapentadol effects on NP.

Modulation of sensitization processes in the management of pain and the importance of descending pathways: a role for tapentadol?

“…Tapentadol has been extensively evaluated in chronic pain conditions, such as back pain, OA, cancer pain, and specifically in neuropathic pain. A detailed presentation of all clinical experiences with tapentadol in these settings goes beyond the aims of the present paper but can be found in a series of recently published reviews [15,[55][56][57]. A paper highlighting the positive impact of tapentadol on QoL has also been recently published [58].…”

Tapentadol is effective in the management of moderate-to-severe cancer-related pain in opioid-naïve and opioid-tolerant patients: a retrospective study

“…Tapentadol's additional mechanism of action (i.e., inhibition of noradrenaline reuptake via α2-adrenoceptors) [28] means that it is able to alleviate both nociceptive pain and neuropathic pain [17][18][19]. This unique characteristic distinguishes tapentadol from most other strong/WHO step III opioids (i.e., morphine and fentanyl) that are mainly muopioid receptor agonists [33].…”

“…Both ascending and descending pathways are implicated in pain and are common sites of actions of analgesics [ 17 , 27 ]. Tapentadol has a dual mechanism of action as a mu-opioid receptor agonist of the ascending pathway and as a noradrenaline reuptake inhibitor of the descending pathway [ 17 , 18 ]. Noradrenaline plays an important role in pain modulation, particularly that of neuropathic pain [ 18 , 28 ].…”

“…Tapentadol is a centrally acting mu-opioid receptor agonist and noradrenaline reuptake inhibitor [16]; both mechanisms of action contribute to its anti-nociceptive and anti-neuropathic pain effects [17][18][19]. Tapentadol has demonstrated to be non-inferior to oxycodone [20] and morphine [21] at reducing pain intensity with better gastrointestinal tolerability in patients with cancer pain.…”

Prolonged encephalopathy and associated nonconvulsive seizures from suspected pregabalin and tapentadol: Two case reports and review of literature

“…1,2 The use of opioids for neuropathic pain is of limited benefit, with poor risk-benefit ratio, 2 but tapentadol have shown some positive results. 2,3 The safety profile of the combination therapy of PGB and tapentadol has been studied is generally considered acceptable. 4,5 However, fatigue, somnolence, behavioral changes, and even seizures have been reported in patients receiving PGB or tapentadol.…”