Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Joint Practices for Obstetrics and Gynecology, Krumbach, Germany.
Support Care Cancer. 2018 Feb;26(2):491-497. doi: 10.1007/s00520-017-3853-y. Epub 2017 Aug 28.
Several patients with advanced cancer suffer from breakthrough cancer pain (BTcP). BTcP is pain exacerbation despite opioid baseline therapy. Fentanyl buccal tablet (FBT) is a rapid-onset opioid for the treatment of BTcP. The aim of this study is to document the feasibility of FBT in patients with BTcP.
The study was performed in 64 centers. Basic pain score was rated on a numeric rating scale (NRS) before and after treatment. BTcP episodes, baseline opioid therapy, and FBT dose were rated as well as individual dose titration, findings on tolerability, patient satisfaction, and safety of the drug.
Two hundred sixty-three patients were available for analysis. Patients rated a basic pain score of 6 (range 2-10) points on an NRS and described an average of 2 to 5 BTcP episodes per day. After titration of FBT, BTcP control was achieved within 5 min in 36%, within 10 min in 68%, and within 15 min in 95%. Basic pain score decreased to a mean NRS of 4 and BTcP episodes decreased to < 1 to 3 episodes per day. BTcP control, onset of action of FBT, potency of FBT, tolerability of FBT, and safety of FBT were rated as excellent or good by 89 to 99% of the patients. Adverse drug reactions were registered in 3%.
Treatment with FBT led to rapid pain relief and reductions in the number of BTcP episodes and patient satisfaction was rated as excellent or good.
一些晚期癌症患者患有突破性癌痛(BTcP)。BTcP 是指尽管有阿片类药物的基础治疗,但疼痛仍加剧。芬太尼颊片剂(FBT)是一种用于治疗 BTcP 的快速起效阿片类药物。本研究旨在记录 FBT 在 BTcP 患者中的可行性。
该研究在 64 个中心进行。治疗前后使用数字评分量表(NRS)评估基本疼痛评分。评估 BTcP 发作、基础阿片类药物治疗和 FBT 剂量以及个体剂量滴定、耐受性发现、患者满意度和药物安全性。
263 名患者可进行分析。患者在 NRS 上评分为 6 分(范围 2-10),平均每天描述 2-5 次 BTcP 发作。在 FBT 滴定后,36%的患者在 5 分钟内控制 BTcP,68%的患者在 10 分钟内控制,95%的患者在 15 分钟内控制。基本疼痛评分降至平均 NRS 4 分,BTcP 发作次数减少至每天 <1-3 次。89%至 99%的患者对 FBT 的 BTcP 控制、起效作用、FBT 的效力、FBT 的耐受性和安全性评为极好或良好。有 3%的患者发生药物不良反应。
FBT 治疗可迅速缓解疼痛,减少 BTcP 发作次数,患者满意度评为极好或良好。