High dose transdermal buprenorphine for moderate to severe pain in spanish pain centres--a retrospective multicenter safety and efficacy study.
OBJECTIVE
To assess the effectiveness of transdermal buprenorphine in patients suffering from moderate to severe pain. Secondary objectives included gathering information about the causes of pain, management of episodic pain, and the safety profile.


METHODS
Retrospective data were collected from 1,465 patients with moderate to severe pain, ie, > or =50 mm on a 0 to 100 mm visual analog scale (VAS), that were switched to transdermal buprenorphine, and received a dose > or =52.5 microg/hour for at least 14 days during the previous 12 months. Pain could have any etiology. Most patients (72.1%) were on tramadol and/or paracetamol (40.7%) before switching to buprenorphine. Using case report forms, efficacy was determined from changes in VAS score compared with 24 hours prior to the first patch application. Safety was evaluated by retrieving information about the nature and incidence of adverse events (AE), whether they were related to the study compound, and the percentage considered being serious.


RESULTS
An absolute reduction of 25.1 points in VAS score was seen over a median period of 3.7 months treatment. In addition, the VAS score was reduced by at least 10% in 88.4% of patients and the incidence of episodic pain fell significantly. Treatment was rated as "Good" or "Very Good" by 82.5% of patients. Out of 1,465 patients, 50.2% experienced an AE; this was related to the drug in 48.8%, and considered serious in 4.0%.


CONCLUSIONS
Transdermal buprenorphine was an effective and considerably safe drug for relieving chronic moderate to severe pain.
Barutell
Carlos
C
Pain Unit, Vall d'Hebrón University Hospital, Barcelona, Spain. cbarutell@affinet.net
Camba
Alberto
A
González-Escalada
José-Ramón
JR
Rodríguez
Manuel
M
D000082:Acetaminophen / Q000008:administration & dosage; D000279:Administration, Cutaneous; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018710:Pain Clinics / Q000706:statistics & numerical data*; D010147:Pain Measurement / Q000187:drug effects; D017288:Pain Threshold / Q000187:drug effects / Q000502:physiology; D010148:Intractable Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D014147:Tramadol / Q000008:administration & dosage; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D014147:Tramadol; D002047:Buprenorphine