Transdermal Buprenorphine in Non-Oncological Moderate-to-Severe Chronic Pain
Transdermal Buprenorphine in Non-Oncological Moderate-to-Severe Chronic Pain
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DOI：
10.2165/1158409-s0-000000000-00000
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发表时间：
2010-01-01
影响因子：
3.2
通讯作者：
Sabato, Alessandro Fabrizio
中科院分区：
文献类型：
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作者：
Gatti, Antonio;Dauri, Mario;Sabato, Alessandro Fabrizio
背景：肌肉骨骼病变是长期非肿瘤性剧烈疼痛和随之而来的身体损伤的最常见原因之一。药物和物理治疗的目的是减轻疼痛、促进功能恢复和提高整体生活质量。药物治疗可能包括使用阿片类药物。目的：评估透皮丁丙诺啡 (TDS) 在长期治疗非肿瘤性、慢性、中度至重度肌肉骨骼疼痛中的疗效和耐受性。研究设计：一项开放标签、前瞻性、单中心、为期 6 个月的研究。环境：“真实世界”门诊环境。患者：患有慢性疼痛的成年患者中度至重度肌肉骨骼疼痛连续入组。 干预：患者最初每72小时接受丁丙诺啡TDS 11.7μg/h（35μg/h贴剂的三分之一）。如果需要，患者可将滴定剂量上调至 17.5 μg/h（35 μg/h 贴剂的二分之一）、23.4 μg/h（35 μg/h 贴剂的三分之二）或 35 μg/h。允许同时使用止吐药。 主要结果指标：主要终点是研究结束时静态和动态疼痛视觉模拟量表 (VAS) 评分的平均减少百分比（10 表示最严重疼痛，0 表示无疼痛）。还评估了生活质量和耐受性。结果：我们招募了 146 名年龄 41-94 岁的患者；他们的基线平均+/- SD静态和动态疼痛VAS评分分别为6.87+/-1.89和7.70+/-1.74。丁丙诺啡 TDS 初始剂量为 11.7 μg/h (n = 139)、17.5 μg/h (n = 4)、23.4 μg/h (n = 1) 和 35 μg/h (n = 2)。 6个月时，89名患者正在接受治疗； 11% (n = 10) 接受 11.7 μg/h、30% (n = 27) 17.5 μg/h、6% (n = 5) 23.4 μg/h 和 53% (n = 47) 35 μg/h。患者在休息和运动时的疼痛均没有显着减轻；平均+/- SD静态和动态疼痛VAS评分分别下降至1.56+/-2.05和3.54+/-2.02。生活质量显着改善（p
Background: Musculoskeletal pathologies are among the most frequent causes of long-term non-oncological severe pain and consequent physical impairment. Aims of pharmacological and physical therapy are to reduce pain, promote functional recovery and improve overall quality of life. Pharmacological therapy may include the use of opioids.Objective: To evaluate the efficacy and tolerability of transdermal buprenorphine (TDS) in the long-term management of non-oncological, chronic, moderate-to-severe musculoskeletal pain.Study Design: An open-label, prospective, single-centre, 6-month study.Setting: A 'real world' outpatient setting.Patients: Adult patients with chronic moderate-to-severe musculoskeletal pain were enrolled consecutively.Intervention: Patients initially received buprenorphine TDS 11.7 mu g/h (one-third of 35 mu g/h patch) every 72 hours. If required, patients could be up-titrated to 17.5 mu g/h (one-half of 35 mu g/h patch), 23.4 mu g/h (two-thirds of 35 mu g/h patch) or 35 mu g/h. Concomitant antiemetics were allowed.Main Outcome Measures: The primary endpoint was percentage mean reduction in static and dynamic pain visual analogue scale (VAS) scores at study end (10 being worst pain, 0 being no pain). Quality of life and tolerability were also assessed.Results: We enrolled 146 patients aged 41-94 years; their baseline mean +/- SD static and dynamic pain VAS scores were 6.87+/-1.89 and 7.70+/-1.74, respectively. Buprenorphine TDS initial dosages were 11.7 mu g/h (n = 139), 17.5 mu g/h (n = 4), 23.4 mu g/h (n = 1) and 35 mu g/h (n = 2). At 6 months, 89 patients were under treatment; 11% (n = 10) were receiving 11.7 mu g/h, 30% (n = 27) 17.5 mu g/h, 6% (n = 5) 23.4 mu g/h and 53% (n = 47) 35 mu g/h. Patients achieved a nonsignificant reduction in pain at rest and in movement; mean +/- SD static and dynamic pain VAS scores decreased to 1.56+/-2.05 and 3.54+/-2.02, respectively. The quality of life improved as shown by significant (p