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Transdermal buprenorphine and fentanyl patches in cancer pain: a network systematic review

Authors Ahn JS, Lin J, Ogawa S, Yuan C, O'Brien T, Le BHC, Bothwell AM, Moon H, Hadjiat Y, Ganapathi A

Received 24 April 2017

Accepted for publication 19 May 2017

Published 18 August 2017 Volume 2017:10 Pages 1963—1972

DOI https://doi.org/10.2147/JPR.S140320

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Minal Joshi

Peer reviewer comments 3

Editor who approved publication: Dr E. Alfonso Romero-Sandoval

Video abstract presented by Tony O'Brien.

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Jin Seok Ahn,1 Johnson Lin,2 Setsuro Ogawa,3 Chen Yuan,4 Tony O’Brien,5,6 Brian HC Le,7 Andrea M Bothwell,8 Hanlim Moon,9 Yacine Hadjiat,9 Abhijith Ganapathi9

1Division of Hematology and Oncology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea; 2Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China; 3Department of Anesthesiology, Nihon University School of Medicine, Tokyo, Japan; 4Department of Oncology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 5Marymount University Hospital and Hospice, 6Cork University Hospital, College of Medicine and Health, University College Cork, Cork, Ireland; 7Department of Palliative Care, Royal Melbourne Hospital, Parkville, VIC, Australia; 8In Vivo Communications (Asia), 9Mundipharma Pte Ltd, Singapore, Singapore

Abstract: Treatment of cancer pain is generally based on the three-step World Health Organization (WHO) pain relief ladder, which utilizes a sequential approach with drugs of increasing potency. Goals of pain management include optimization of analgesia, optimization of activities of daily living, minimization of adverse effects, and avoidance of aberrant drug taking. In addition, it is recommended that analgesic regimens are individualized and simplified to help ensure patient compliance and should provide the least invasive, easiest, and safest route of opioid administration to ensure adequate analgesia. Buprenorphine and fentanyl are two opioids available for the relief of moderate-to-severe cancer pain. Available clinical data regarding the transdermal (TD) formulations of these opioids and the extent to which they fulfill the recommendations mentioned earlier are systematically reviewed, with the aim of providing additional information for oncologists and pain specialists regarding their comparative use. Due to lack of studies directly comparing TD buprenorphine with TD fentanyl, data comparing these with other step-3 opioids are also evaluated in a network fashion.

Keywords:
analgesia, cancer pain management, chronic pain/drug therapy, drug evaluation, pain management, patch analgesics

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