Switching from transdermal drugs: An observational "N of 1" study of fentanyl and buprenorphine
Switching from transdermal drugs: An observational "N of 1" study of fentanyl and buprenorphine
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DOI：
10.1016/j.jpainsymman.2007.01.006
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发表时间：
2007-11-01
影响因子：
4.7
通讯作者：
Mangione, Salvatore
中科院分区：
文献类型：
--
作者：
Mercadante, Sebastiano;Porzio, Giampiero;Mangione, Salvatore
本研究的目的是证实，使用假定为等镇痛的剂量，同时使用经皮芬太尼（TTS FE）和丁丙诺啡（TTS BU）可能是可行的，不会产生重要后果。在接受稳定剂量TTS FE或TTS BU的癌痛志愿者样本中进行了一项前瞻性“N of 1”研究，并充分控制了疼痛和症状。在研究设计中，每位患者提供了从一种阿片类药物转换为另一种阿片类药物之前和之后的数据，然后返回到前一种阿片类药物。16例接受每日稳定剂量0.6或1.2 mg TTS FE的患者转换为TTS BU，FE-BU比为0.6-0.8。3天后，取出TTS BU贴片，并将TTS IT贴片再放置3天。6例接受TTS B U的患者转换为TTS FE，然后转回TTS BU，剂量考虑相同。转换期间和两个不同序列之间的疼痛和症状强度变化无统计学差异。在相同的时间间隔内，口服吗啡的补救剂量没有显著变化。接受稳定剂量TTS FE或TTS BU的癌症患者可以安全地转换为替代透皮阿片类药物。应进行进一步的研究，以收集有关TTS BU与其他阿片类药物在不同剂量和不同临床条件下使用的数据。
The aim of this study was to confirm that the concomitant Presence of transdermal fentanyl (TTS FE) and buprenorphine (TTS BU) may be feasible without important consequences, using doses presumed to be equianalgesic. A prospective "N of 1" study was carried out in a sample of volunteers with cancer pain receiving stable doses of TTS FE or TTS BU, with adequate pain and symptom control. In the study design, each patient provided data before and after a switch from one opioid to the other and then back to the previous one. Sixteen patients receiving daily stable doses of 0.6 or 1.2 mg of TTS FE were switched to TTS BU using an FE-BU ratio of 0.6-0.8. After three days, the TTS BU patch was removed and TTS IT patch was placed for another three days. Six patients receiving TTS B U were switched to TTS FE and then rotated back to TTS BU with the same dosing considerations. No statistical differences in changes in pain and symptom intensity during switching and between the two different sequences were observed. No significant changes in rescue doses of oral morphine were reported at the same intervals. Cancer patients receiving stable doses of TTS FE or TTS BU can be safely switched to the alternative transdermal opioid. Further studies should be performed to gather data about the use of TTS BU with other opioids, at different doses, and in different clinical conditions.