title: Indirect treatment comparison of two non-invasive patient-controlled analgesia treatments for acute post-operative pain management.
abstract: OBJECTIVE
  To evaluate the relative clinical efficacy, safety, and tolerability associated with two non-invasive patient-controlled analgesia (PCA) treatments, sufentanil sublingual tablet system (SSTS) and fentanyl iontophoretic patient-controlled transdermal system (PCTS). These two treatments have recently been approved in the EU for the management of acute moderate-to-severe post-operative pain in adult patients.
  
  
  METHODS
  As no head-to-head trials comparing SSTS and PCTS currently exist, indirect treatment comparison (ITC) analyses were conducted to evaluate SSTS or PCTS versus intravenous (IV) morphine PCA.
  
  
  RESULTS
  Five studies, four assessing PCTS and one assessing SSTS, were included in this analysis. SSTS had statistical or numerical advantages over PCTS for both patient global assessment (PGA) and healthcare professional global assessment (HPGA) outcomes at all time points investigated. SSTS was also associated with greater patient ease of use (weighted mean difference [WMD]: 0.13; 95% confidence interval [CI]: -0.02-0.28) and a higher patient satisfaction score (WMD: 0.31; 95% CI: 0.05-0.57; p = .019) compared with PCTS. In terms of tolerability, all-cause withdrawals from treatment were reported to be less likely with SSTS (risk ratio: 0.65; 95% CI: 0.42-1.02). No significant differences were observed between SSTS and PCTS in terms of safety and adverse events.
  
  
  CONCLUSIONS
  In the absence of direct head-to-head data, the combination of promising phase III trial results compared to IV morphine PCA, a SLR comparison against other opioid treatments, and the results of this exploratory analysis present a strong rationale in support of SSTS as a key option for management of post-operative pain.
authors.affiliation: a Grünenthal GmbH , Aachen , Germany.
authors.forename: Pablo
authors.initials: P
authors.lastname: Katz
authors.affiliation: b Parexel International , Chandigarh , UT , India.
authors.forename: Shweta
authors.initials: S
authors.lastname: Takyar
authors.affiliation: c AcelRx Pharmaceuticals , Redwood City , CA , USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Palmer
authors.affiliation: a Grünenthal GmbH , Aachen , Germany.
authors.forename: Hiltrud
authors.initials: H
authors.lastname: Liedgens
mesh_terms: D059787:Acute Pain / Q000188:drug therapy; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007478:Iontophoresis; D009020:Morphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy*; D017409:Sufentanil / Q000008:administration & dosage*; D013607:Tablets
chemical_list: D000701:Analgesics, Opioid; D013607:Tablets; D009020:Morphine; D017409:Sufentanil; D005283:Fentanyl
keywords: Analgesia; Iontophoresis; analgesics; fentanyl; opioid; pain; patient-controlled; post-operative; sufentanil; tablets