Effectiveness and tolerability of transdermal buprenorphine patches: a multicenter, prospective, open-label study in Asian patients with moderate to severe chronic musculoskeletal pain

BMC Musculoskeletal Disorders

Research Article

Chi Chiu Mok¹  Chun Kee Chung²  Dong Ah Shin³  Do Heum Yoon³  Yong In⁴  Seong-Il Bin⁵  Young-Wan Moon⁶  Hyoungmin Kim⁷  Hanlim Moon⁸  Dora You⁸  Tony Kwun-Tung Ng⁹  Simon Kin-Cheong Chan^1,10  Juan Javier Lichauco^1,11  Ester Gonzales Penserga^1,12 

[1] Department of Medicine, Tuen Mun Hospital, Hong Kong, SAR, China;Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea;Department of Brain and Cognitive Science, Seoul National University College of Natural Science, Seoul, South Korea;Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Severance Hospital, 134 Shinchon-dong Seodaemun-gu, 120–752, Seoul, South Korea;Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;Department of Orthopedic Surgery, Asan Medical Center, Seoul, South Korea;Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea;Mundipharma Pte Ltd, Asia Square Tower 2, Singapore;Pain Management Unit, Department of Anaesthesia and Intensive Care, Tuen Mun Hospital, Hong Kong, SAR, China;Pain Management Unit, Department of Anaesthesiology and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China;Section of Rheumatology, Department of Medicine, St. Luke’s Medical Center, Manila, Philippines;Section of Rheumatology, Department of Medicine, University of the Philippines College of Medicine-Philippine General Hospital, Manila, Philippines;

关键词: Transdermal buprenorphine;    Asian;    Chronic non-malignant pain;    Musculoskeletal;    Pain score;    Quality of life;    Sleep quality;    Effectiveness;    Tolerability;   

DOI  :  10.1186/s12891-017-1664-4

 received in 2016-09-26, accepted in 2017-07-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundWe examined the effectiveness and tolerability of transdermal buprenorphine (TDB) treatment in real-world setting in Asian patients with musculoskeletal pain.MethodsThis was an open-label study conducted in Hong Kong, Korea, and the Philippines between June 2013 and April 2015. Eligible patients fulfilled the following criteria: 18 to 80 years of age; clinical diagnosis of osteoarthritis, rheumatoid arthritis, low back pain, or joint/muscle pain; chronic non-malignant pain of moderate to severe intensity (Box-Scale-11 [BS-11] pain score ≥ 4), not adequately controlled with non-opioid analgesics and requiring an opioid for adequate analgesia; and no prior history of opioid treatment. Patients started with a 5 μg/h buprenorphine patch and were titrated as necessary to a maximum of 40 μg/h over a 6-week period to achieve optimal pain control. Patients continued treatment with the titrated dose for 11 weeks. The primary efficacy endpoint was the change in BS-11 pain scores. Other endpoints included patients’ sleep quality and quality of life as assessed by the 8-item Global Sleep Quality Assessment Scale (GSQA) questionnaire and the EuroQol Group 5-Dimension Self-Report Questionnaire-3 Level version (EQ-5D-3 L), respectively. Tolerability was assessed by collecting adverse events.ResultsA total of 114 eligible patients were included in the analysis. The mean BS-11 score at baseline was 6.2 (SD 1.6). Following initiation of TDB, there was a statistically significant improvement in BS-11 score from baseline to visit 3 (least squares [LS] mean change: -2.27 [95% CI -2.66 to −1.87]), which was maintained till the end of the study (visit 7) (LS mean change: −2.64 [95% -3.05 to −2.23]) (p < 0.0001 for both). The proportion of patients who rated sleep quality as ‘good’ increased from 14.0% at baseline to 26.9% at visit 6. By visit 6, the mean EQ VAS score increased by 7.7 units (SD 17.9). There were also significant improvements in patients’ levels of functioning for all EQ-5D-3 L dimensions from baseline at visit 6 (p < 0.05 for all). Seventy-eight percent of patients reported TEAEs and 22.8% of patients discontinued due to TEAEs. TEAEs were generally mild to moderate in intensity (96.5%).ConclusionsTDB provides effective pain relief with an acceptable tolerability profile over the 11-week treatment period in Asian patients with chronic musculoskeletal pain. More studies are needed to examine the long-term efficacy and safety of TBD treatment in this patient population.Trial registrationClinicalTrials.gov NCT01961271. Registered 7 October 2013 (retrospectively registered; first patient was enrolled on 28 June 2013 and last patient last visit date was 26 Apr 2015).

【 授权许可】

CC BY   
© The Author(s). 2017