Universität zu Köln

Ueberall, Michael A., Lorenzl, Stefan, Lux, Eberhard A., Voltz, Raymond and Perelman, Michael (2016). Efficacy, safety, and tolerability of fentanyl pectin nasal spray in patients with breakthrough cancer pain. J. Pain Res., 9. S. 571 - 586. ALBANY: DOVE MEDICAL PRESS LTD. ISSN 1178-7090

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Abstract

Objective: Assessment of analgesic effectiveness, safety, and tolerability of fentanyl pectin nasal spray (FPNS) in the treatment of breakthrough cancer pain (BTcP) in routine clinical practice. Methods: A prospective, open-label, noninterventional study (4-week observation period, 3 month follow-up) of opioid-tolerant adults with BTcP in 41 pain and palliative care centers in Germany. Standardized BTcP questionnaires and patient diaries were used. Evaluation was made of patient-reported outcomes with respect to time to first effect, time to maximum effect, BTcP relief, as well as changes in BTcP-related impairment of daily life activities, quality-of-life restrictions, and health care resource utilization. Results: A total of 235 patients were recruited of whom 220 completed all questionnaires and reported on 1,569 BTcP episodes. Patients reported a significant reduction of maximum BTcP intensity (11-stage numerical rating scale [0= no pain, 10= worst pain conceivable]) with FPNS (mean +/- standard deviation = 2.8 +/- 2.3) compared with either that reported at baseline (8.5 +/- 1.5), experienced immediately before FPNS application (7.4 +/- 1.7), or that achieved with previous BTcP medication (6.0 +/- 2.0; P<0.001 for each comparison). In 12.3% of BTcP episodes, onset of pain relief occurred = 2 minutes and in 48.4% <= 5 minutes; maximum effects were reported within 10 minutes for 37.9% and within 15 minutes for 79.4%. By the end of the study, there had been significant improvements versus baseline in BTcP-related daily life activities (28.3 +/- 16.9 vs 53.1 +/- 11.9), physical (35.9 +/- 8.4 vs 26.8 +/- 6.5), and mental quality of life (38.7 +/- 8.5 vs 29.9 +/- 7.9) (P<0.001 for each comparison vs baseline); in addition, health care resource utilization requirements directly related to BTcP were reduced by 67.5%. FPNS was well tolerated; seven patients (3.2%) experienced eight treatment-emergent adverse events of which none was serious. There were no indicators of misuse or abuse. Conclusion: FPNS provided rapid and highly effective BTcP relief in opioid-tolerant cancer patients with substantial improvements in daily functioning and quality of life. FPNS was well tolerated and associated with significant reductions in health care resource utilization and nursing assistance.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ueberall, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lorenzl, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lux, Eberhard A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED Perelman, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-288538
DOI:	10.2147/JPR.S106177
Journal or Publication Title:	J. Pain Res.
Volume:	9
Page Range:	S. 571 - 586
Date:	2016
Publisher:	DOVE MEDICAL PRESS LTD
Place of Publication:	ALBANY
ISSN:	1178-7090
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OUTCOME MEASURES; VALIDATION; RECOMMENDATIONS; ACCEPTABILITY; MANAGEMENT; INTENSITY; CROSSOVER; MORPHINE; OPIOIDS Multiple languages Clinical Neurology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/28853