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A Phase III study to assess the clinical utility of low-dose fentanyl transdermal system in patients with chronic nonmalignant pain.
Curr Med Res Opin. 2006 Aug; 22(8):1493-501.CM

Abstract

BACKGROUND

The transdermal fentanyl delivery system (fentanyl TTS; Duragesic) is currently widely available in patch strengths of 25, 50, 75, and 100 microg/h. However, a lower dose of 12 microg/h would allow optimal titration and fine tuning of the analgesic effect, and may be beneficial in certain patient populations such as the elderly or opioid-naïve. A 12 microg/h fentanyl TTS patch has been developed, and the clinical efficacy and safety tested in this single-arm, non-randomized, open-label, multicenter, 28-day trial in opioid-exposed and -naïve patients with moderate to severe pain for at least 6 months.

PATIENTS

Patients were treated with fentanyl TTS for 28 days in an intent-to-treat manner starting at 12 microg/h (one patch), titrated upwards in increments of 12 mug/h to a maximum dose of 36 microg/h (three patches).

RESULTS

A total of 227 patients were enrolled. The majority of patients with a "global assessment of therapy" of fair/poor at baseline (63.4%) improved to good/very good, while 28.9% of patients with an assessment of good/very good at baseline worsened to fair/poor at endpoint. The average pain intensity levels for the efficacy evaluable population steadily decreased over the course of the trial. The adverse event (AE) profile of fentanyl TTS in this trial was generally similar to that identified in previous fentanyl TTS trials, and no unexpected safety issues or AEs were noted. Furthermore, the drop-out rate in this trial was lower than has been noted in previous trials.

CONCLUSION

This trial demonstrated that the lower 12 microg/h dose of fentanyl TTS provided a therapeutic benefit in non-malignant chronic pain, with a similar AE rate but a lower drop-out rate than that seen in trials at higher doses. This lower dose may, therefore, be of particular benefit to elderly or opioid-naïve patients.

Authors+Show Affiliations

Pain Management Group, Department of Neurology, Boston University Medical Center, 715 Albany Street C-3, Boston, MA 02118, USA. James.Otis@bmc.orgNo affiliation info available

Pub Type(s)

Clinical Trial, Phase III
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16870074

Citation

Otis, James, and Margaret Rothman. "A Phase III Study to Assess the Clinical Utility of Low-dose Fentanyl Transdermal System in Patients With Chronic Nonmalignant Pain." Current Medical Research and Opinion, vol. 22, no. 8, 2006, pp. 1493-501.
Otis J, Rothman M. A Phase III study to assess the clinical utility of low-dose fentanyl transdermal system in patients with chronic nonmalignant pain. Curr Med Res Opin. 2006;22(8):1493-501.
Otis, J., & Rothman, M. (2006). A Phase III study to assess the clinical utility of low-dose fentanyl transdermal system in patients with chronic nonmalignant pain. Current Medical Research and Opinion, 22(8), 1493-501.
Otis J, Rothman M. A Phase III Study to Assess the Clinical Utility of Low-dose Fentanyl Transdermal System in Patients With Chronic Nonmalignant Pain. Curr Med Res Opin. 2006;22(8):1493-501. PubMed PMID: 16870074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Phase III study to assess the clinical utility of low-dose fentanyl transdermal system in patients with chronic nonmalignant pain. AU - Otis,James, AU - Rothman,Margaret, PY - 2006/7/28/pubmed PY - 2007/1/27/medline PY - 2006/7/28/entrez SP - 1493 EP - 501 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 22 IS - 8 N2 - BACKGROUND: The transdermal fentanyl delivery system (fentanyl TTS; Duragesic) is currently widely available in patch strengths of 25, 50, 75, and 100 microg/h. However, a lower dose of 12 microg/h would allow optimal titration and fine tuning of the analgesic effect, and may be beneficial in certain patient populations such as the elderly or opioid-naïve. A 12 microg/h fentanyl TTS patch has been developed, and the clinical efficacy and safety tested in this single-arm, non-randomized, open-label, multicenter, 28-day trial in opioid-exposed and -naïve patients with moderate to severe pain for at least 6 months. PATIENTS: Patients were treated with fentanyl TTS for 28 days in an intent-to-treat manner starting at 12 microg/h (one patch), titrated upwards in increments of 12 mug/h to a maximum dose of 36 microg/h (three patches). RESULTS: A total of 227 patients were enrolled. The majority of patients with a "global assessment of therapy" of fair/poor at baseline (63.4%) improved to good/very good, while 28.9% of patients with an assessment of good/very good at baseline worsened to fair/poor at endpoint. The average pain intensity levels for the efficacy evaluable population steadily decreased over the course of the trial. The adverse event (AE) profile of fentanyl TTS in this trial was generally similar to that identified in previous fentanyl TTS trials, and no unexpected safety issues or AEs were noted. Furthermore, the drop-out rate in this trial was lower than has been noted in previous trials. CONCLUSION: This trial demonstrated that the lower 12 microg/h dose of fentanyl TTS provided a therapeutic benefit in non-malignant chronic pain, with a similar AE rate but a lower drop-out rate than that seen in trials at higher doses. This lower dose may, therefore, be of particular benefit to elderly or opioid-naïve patients. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/16870074/A_Phase_III_study_to_assess_the_clinical_utility_of_low_dose_fentanyl_transdermal_system_in_patients_with_chronic_nonmalignant_pain_ L2 - https://www.tandfonline.com/doi/full/10.1185/030079906X115540 DB - PRIME DP - Unbound Medicine ER -