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Considerations in selecting rapid-onset opioids for the management of breakthrough pain

Authors Perelman M, Leake S

Received 26 March 2013

Accepted for publication 27 March 2013

Published 5 June 2013 Volume 2013:6 Pages 435—436


Michael Perelman, Suzan Leake

Archimedes Pharma, Bedminister, NJ, USA

We read with great interest the recent publication by Smith.1 This article provides a valuable perspective on the selection of an agent to manage breakthrough pain. Smith recognizes the importance of a fast onset-of-action and the identification by Farrar et al2 of a 33% (often ≥2 point) change in the pain intensity difference as a measure of a ‘clinically important improvement’. For these reasons, Smith focuses on the various transmucosal fentanyl formulations that offer a rapid onset and he provides a nice summary of the key features of each of the available products.

View original paper by Howard S Smith.

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