title: Pharmacokinetics of sublingual sufentanil tablets and efficacy and safety in the management of postoperative pain.
abstract: OBJECTIVE
  A sublingual sufentanil tablet is being developed as a potential alternative to intravenous (IV) opioids for the management of postoperative pain. The objective of these studies was to evaluate the pharmacokinetics, efficacy, and safety of sublingual sufentanil tablets for postoperative pain management.
  
  
  METHODS
  The pharmacokinetics of sublingual sufentanil 10 and 80 µg were compared with IV sufentanil in 12 subjects in a phase 1 study. The safety and efficacy of sublingual sufentanil (5-15 µg) were evaluated in double-blind, randomized, placebo-controlled phase 2 studies in patients undergoing knee replacement surgery (n = 101) or open abdominal (ABD) surgery (n = 94). The primary efficacy measurement was the summed pain intensity difference compared with baseline over 12 hours (SPID-12).
  
  
  RESULTS
  Sublingual sufentanil pharmacokinetics were dose proportional following single doses of 10 and 80 µg. Plasma half-time (time from peak plasma concentration to 50% of peak concentration) was 80 to 90 minutes for sublingual sufentanil compared with 15 minutes or less for IV sufentanil. In the phase 2 studies, greater SPID-12 scores (ie, lower pain intensity) compared with placebo were observed for sublingual sufentanil 15 µg in the knee replacement study (P < 0.05) and for 10 and 15 µg in the ABD study (P < 0.01). All doses of sublingual sufentanil were well tolerated, and the incidence of adverse events was similar between the sublingual sufentanil and placebo groups.
  
  
  CONCLUSIONS
  Sufentanil formulated as a sublingual solid dosage form provides a duration of action that allows effective analgesia for postoperative patients in a medically supervised setting.
authors.affiliation: Memorial Hermann Memorial City Medical Center, Houston, TX, USA.
authors.forename: Harold S
authors.initials: HS
authors.lastname: Minkowitz
authors.forename: Neil K
authors.initials: NK
authors.lastname: Singla
authors.forename: Mark A
authors.initials: MA
authors.lastname: Evashenk
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Hwang
authors.forename: Yu-Kun
authors.initials: YK
authors.lastname: Chiang
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Hamel
authors.forename: Pamela P
authors.initials: PP
authors.lastname: Palmer
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics*; D000704:Analysis of Variance; D019540:Area Under Curve; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001682:Biological Availability; D005260:Female; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D016018:Least-Squares Analysis; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control*; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics*; D013607:Tablets; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D013607:Tablets; D017409:Sufentanil