title: A new once-a-day fentanyl citrate patch (Fentos Tape) could be a new treatment option in patients with end-of-dose failure using a 72-h transdermal fentanyl matrix patch.
abstract: OBJECTIVE
  The recommended dosing interval for transdermal fentanyl is every 72 h. However, some patients will have "end-of-dose failure," which may be seen as an increase of episodes of severe pain flares at the third day after application of the patch. A new once-a-day fentanyl patch was developed in Japan since 2010. This study aimed to assess the efficacy of the once-a-day fentanyl citrate patch for patients with cancer-related pain receiving the 72-h transdermal fentanyl not lasting 72 h.
  
  
  METHODS
  We performed a cross-sectional retrospective analysis of 445 inpatients with the 72-h transdermal fentanyl at Higashi Sapporo Hospital. We could switch to the once-a-day fentanyl citrate patch if patients reported inadequate pain relief beyond 48 h after application of the 72-h transdermal fentanyl. Patients recorded baseline scores for background pain intensity (PI) and the frequency of use of daily rescue medication for breakthrough cancer pain (BTcP).
  
  
  RESULTS
  Of all patients, 10.1% showed the increase in PI of 30% or more baseline PI on the third day after application of the 72-h transdermal fentanyl. Of patients, 84.4% were converted from equivalent dose of the 72-h transdermal fentanyl to the once-a-day fentanyl citrate patch. On the third day after switching, 60.5% of patients showed a reduction of more than 30% from baseline PI. Switching to the once-a-day fentanyl citrate patch significantly reduced the mean frequency of daily rescue dose for BTcP.
  
  
  CONCLUSIONS
  A once-a-day fentanyl citrate patch provided stable pain control. Its use may be considered as the dominant strategy for patients receiving a 72-h transdermal fentanyl not lasting 72 h.
authors.affiliation: Division of Palliative Medicine, Sapporo Kiyota Hospital, 1-1-1-1 Shinei, Kiyota-ku, Sapporo, Hokkaido, 004-0831, Japan. kkoikekyh@gmail.com.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.affiliation: Division of Internal Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Terui
authors.affiliation: Division of Palliative Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Nagasako
authors.affiliation: Division of Palliative Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Iori
authors.initials: I
authors.lastname: Horiuchi
authors.affiliation: Division of Palliative Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Machino
authors.affiliation: Division of Internal Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kusakabe
authors.affiliation: Division of Internal Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirayama
authors.affiliation: Division of Internal Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Mihara
authors.affiliation: Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Yamakage
authors.affiliation: Department of Medical Oncology and Hematology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
authors.affiliation: Division of Palliative Medicine, Sapporo Kiyota Hospital, 1-1-1-1 Shinei, Kiyota-ku, Sapporo, Hokkaido, 004-0831, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Nishisato
authors.affiliation: Division of Palliative Medicine, Higashi Sapporo Hospital, Sapporo, Hokkaido, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Ishitani
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D059390:Breakthrough Pain / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors; D057968:Transdermal Patch
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: Breakthrough cancer pain; End-of-dose failure; Fentanyl citrate; Opioid switch; Transdermal fentanyl