Janssen Global Services, Beerse, Belgium.
Pain Med. 2012 Sep;13(9):1110-20. doi: 10.1111/j.1526-4637.2012.01454.x. Epub 2012 Jul 30.
Opioid treatment effectiveness may be best compared using definitions of treatment response, which combine measures assessing pain reduction and the occurrence of adverse events (AEs). This analysis of data from two phase III clinical trials was conducted to examine the pain relief and tolerability (PRT) balance of immediate release (IR) tapentadol and oxycodone in patients with moderate to severe osteoarthritis (OA) or low back pain.
This was a post hoc analysis of two multicenter, randomized, double-blind studies (10-day and 90-day) that evaluated the efficacy and safety of tapentadol IR in patients with moderate-severe OA pain. PRT was defined as adequate pain reduction (30% or 50% pain intensity improvement from baseline) and no gastrointestinal AE or other type of treatment-emergent AE. The percentage of patients and mean number of days per patient meeting the PRT criteria were summarized.
In the 10-day trial, the percentages of patients meeting PRT criteria (30% reduction) for both tapentadol groups were consistently above that for oxycodone 10 mg, although only significantly different for the 50 mg formulation. The mean number of days per patient meeting the PRT criteria was 3.7, 3.2, and 2.3 days for tapentadol 50 mg, 75 mg and oxycodone 10 mg, respectively. No significant difference between the groups was observed using the 50% pain reduction criterion. For the 90-day trial, using multiple definitions, tapentadol IR showed a significantly higher proportion of days meeting PRT criteria.
Pain reduction and tolerability are both important attributes of an effective analgesic treatment. Based on data from two trials, tapentadol IR produced an improved PRT balance compared with oxycodone IR.
阿片类药物治疗效果最好通过治疗反应的定义进行比较,该定义综合了评估疼痛缓解和不良事件(AE)发生的措施。对两项 III 期临床试验的数据进行了这项分析,旨在研究中重度骨关节炎(OA)或腰痛患者中即刻释放(IR)酒石酸布托啡诺和羟考酮的疼痛缓解和耐受性(PRT)平衡。
这是两项多中心、随机、双盲研究(10 天和 90 天)的事后分析,评估了 IR 酒石酸布托啡诺治疗中重度 OA 疼痛患者的疗效和安全性。PRT 定义为疼痛缓解充分(基线疼痛强度改善 30%或 50%),且无胃肠道 AE 或其他类型的治疗出现的 AE。总结符合 PRT 标准的患者百分比和每位患者的平均天数。
在 10 天的试验中,符合 PRT 标准(疼痛减轻 30%)的酒石酸布托啡诺组患者百分比始终高于羟考酮 10 mg 组,尽管仅在 50 mg 制剂中差异显著。符合 PRT 标准的每位患者的平均天数分别为酒石酸布托啡诺 50 mg、75 mg 和羟考酮 10 mg 组的 3.7、3.2 和 2.3 天。使用 50%疼痛减轻标准时,各治疗组间无显著差异。对于 90 天的试验,使用多种定义,IR 酒石酸布托啡诺显示符合 PRT 标准的天数比例明显更高。
疼痛缓解和耐受性都是有效镇痛治疗的重要属性。基于两项试验的数据,IR 酒石酸布托啡诺与 IR 羟考酮相比,产生了改善的 PRT 平衡。