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First evaluation of tapentadol oral solution for the treatment of moderate to severe acute pain in children aged 6 to <18

Authors Finkel JC, Goldberg J, Rosenburg R, Ariyawansa J, Sun T, Ochs-Ross R, Zannikos P, Zhang L, Etropolski M

Received 7 December 2018

Accepted for publication 27 May 2019

Published 28 June 2019 Volume 2019:12 Pages 1925—1936


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Katherine Hanlon

Julia C Finkel,1 Jutta Goldberg,2 Ronald Rosenburg,2 Jay Ariyawansa,3 Tao Sun,3 Rachel Ochs-Ross,3 Peter Zannikos,3 Liping Zhang,3 Mila Etropolski3

1Children’s National Medical Center, Washington, DC, USA; 2Grünenthal GmbH, Aachen, Germany; 3Janssen Pharmaceutical, Titusville, NJ, USA

Background: This is the first clinical trial in the global pediatric clinical development program for the use of the analgesic tapentadol in children and adolescents.
Patients and methods: This multicenter, open-label clinical trial investigated pharmacokinetics, safety and tolerability, and efficacy of tapentadol and its major metabolite tapentadol-O-glucuronide after administration of a single dose of tapentadol oral solution (OS) in pediatric patients aged 6 to <18 years experiencing moderate to severe acute pain after surgery. Efficacy (change in pain intensity after tapentadol intake) was assessed in an exploratory manner using the McGrath Color Analog Scale and Faces Pain Scale-Revised. Adverse events were monitored throughout the trial.
Results: Forty-four patients who received a single dose of 1 mg/kg tapentadol OS were included in this investigation. Maximum serum concentrations of tapentadol (111 ng/mL) and tapentadol-O-glucuronide (2,400 ng/mL) observed in this trial were within the range of individual maximum concentrations observed in healthy adults administered a comparable dose (range for tapentadol 23.2–129 ng/mL, for tapentadol-O-glucuronide 1,040–4,070 ng/mL). Following tapentadol administration, pain intensity scores improved from baseline at all timepoints. Treatment-emergent adverse events, none of which were serious, were experienced by 45.5% of the patients; the most commonly reported were vomiting (29.5%) and nausea (9.1%).
Conclusions: Tapentadol OS administered as a single dose of 1 mg/kg in children aged 6 to <18 years was generally well tolerated and produced similar serum concentrations as administration of 50–100 mg tapentadol immediate-release tablets in adults. A decrease in postsurgical pain was observed using exploratory subject-reported pain assessments. Tapentadol OS may provide a new treatment option in the management of moderate to severe acute pain in children and adolescents.

Keywords: tapentadol, acute pain, children, μ-opioid, pharmacokinetics, efficacy and safety

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