| Autor: |
Webster, Lynn, Gruener, Daniel, Kirby, Todd, Qinfang Xiang, Tzanis, Evan, Finn, Andrew |
| Předmět: |
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| Zdroj: |
Pain Medicine; May2016, Vol. 17 Issue 5, p899-907, 9p, 1 Diagram, 4 Charts, 3 Graphs |
| Abstrakt: |
Objective Assess whether patients with chronic pain receiving 80 to 220mg oral morphine sulfate equivalent of a full μ-opioid agonist could be transitioned to buccal buprenorphine at approximately 50% of their full dose without inducing opioid withdrawal or sacrificing analgesic efficacy. Methods. A randomized, double-blind, doubledummy, active-controlled, two-period crossover study in adult patients receiving around-the-clock ull opioid agonist therapy and confirmed to be opioid dependent by naloxone challenge. Study doses were substituted at the time of the regular dose schedule for each patient. The primary endpoint was the proportion of patients with a maximum Clinical Opiate Withdrawal Scale score ≥13 moderate withdrawal) or use of rescue medication. Results. 35 subjects on ≥80mg morphine sulfate equivalent per day were evaluable for opioid withdrawal. One patient during buccal buprenorphine reatment and two during 50% full l-opioid agonist reatment experienced opioid withdrawal of at least moderate intensity. The mean maximum Clinical Opiate Withdrawal Scale scores were similar, and numerically lower on buccal buprenorphine. There were no significant differences in pain ratings between treatments. The most frequent adverse events with buccal buprenorphine were headache 19%), vomiting (13%), nausea, diarrhea, and drug withdrawal syndrome (each 9%), and with full lopioid agonist were headache (16%), drug withdrawal syndrome (13%), and nausea (6%). Conclusions. Chronic pain patients treated with around-the-clock full μ-opioid agonist therapy can be switched to buccal buprenorphine (a partial l-opioid agonist) at approximately 50% of the full l-opioid agonist dose without an increased risk of opioid withdrawal or loss of pain control. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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