Universität zu Köln

Simon, Steffen T., Koeskeroglu, Peyla, Gaertner, Jan ORCID: 0000-0002-8824-7117 and Voltz, Raymond (2013). Fentanyl for the Relief of Refractory Breathlessness: A Systematic Review. J. Pain Symptom Manage., 46 (6). S. 874 - 887. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1873-6513

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Abstract

Context. Fentanyl is a potent opioid that has been proven to provide effective treatment for breakthrough cancer pain. Although opioids are the only drug group with evidence for the symptomatic treatment of breathlessness, evidence about the efficacy of fentanyl for the relief of breathlessness is unknown. Objectives. We performed a systematic review to evaluate the current evidence for the use of fentanyl for the relief of breathlessness. Methods. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendation for systematic reviews. Four databases (MEDLINE, EMBASE, Cochrane Library, International Pharmaceutical Abstracts) were screened using fentanyl and dyspnoea (and synonyms) as search terms. Hand search and contact with relevant authors completed the search. Results. A total of 622 references were retrieved, 13 of which met the inclusion criteria for this review. Two randomized controlled trials (RCTs) evaluated fentanyl for breathlessness, but one only included two patients. The other studies were before-after (n = 2) and case studies (n = 9). All studies reported successful relief of breathlessness after fentanyl application, but the only (pilot-) RCT failed to demonstrate a statistically significant difference compared with placebo. The nature and incidence of adverse events were comparable with other opioids, and no respiratory depression was observed. Conclusion. Descriptive studies yielded promising results for the use of fentanyl for the relief of breathlessness; however, efficacy trials are lacking. Fully powered RCTs are warranted to determine the efficacy of fentanyl for breathlessness relief, but these require pilot studies to evaluate effective size, study procedures, and outcome measures. (C) 2013 U. S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Simon, Steffen T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koeskeroglu, Peyla UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaertner, Jan UNSPECIFIED orcid.org/0000-0002-8824-7117 UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-471543
DOI:	10.1016/j.jpainsymman.2013.02.019
Journal or Publication Title:	J. Pain Symptom Manage.
Volume:	46
Number:	6
Page Range:	S. 874 - 887
Date:	2013
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1873-6513
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NEBULIZED FENTANYL; BREAKTHROUGH PAIN; PALLIATIVE CARE; DYSPNEA; CITRATE; MANAGEMENT; OPIOIDS Multiple languages Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47154