Transdermal Buprenorphine in Non-Oncological Moderate-to-Severe Chronic Pain

摘要: Background: Musculoskeletal pathologies are among the most frequent causes of long-term non-oncological severe pain and consequent physical impairment. Aims pharmacological therapy to reduce pain, promote functional recovery improve overall quality life. Pharmacological may include use opioids. Objective: To evaluate efficacy tolerability transdermal buprenorphine (TDS) in management non-oncological, chronic, moderate-to-severe musculoskeletal pain. Study Design: An open-label, prospective, single-centre, 6-month study. Setting: A ‘real world’ outpatient setting. Patients: Adult patients with chronic were enrolled consecutively. Intervention: Patients initially received TDS 11.7 µg/h (onethird 35 patch) every 72 hours. If required, could be uptitrated 17.5 (one-half 35µg/h patch), 23.4 (two-thirds or µg/h. Concomitant antiemetics allowed. Main Outcome Measures: The primary endpoint was percentage mean reduction static dynamic visual analogue scale (VAS) scores at study end (10 being worst 0 no pain). Quality life also assessed. Results: We 146 aged 41–94 years; their baseline mean± SD VAS 6.87±1.89 7.70 ± 1.74, respectively. Buprenorphine initial dosages (n=139), (n = 4), (n= 1) 2). At 6 months, 89 under treatment; 11% (n=10) receiving 11.7µg/h, 30% 27) µg/h, 6% 5) 53% 47) 35µg/h. achieved a nonsignificant rest movement; decreased 1.56 2.05 3.54 2.02, improved as shown by significant (p< 0.01) increases from all items relating mental health on Short-Form 36 survey. experienced daily social activities according (p<0.01) increase Karnofsky Performance Status sub-item scores. Twenty-three discontinued treatment because adverse events, which mainly gastrointestinal CNS-related. Conclusions: Low-dose had good analgesic efficacy, early 1 month after initiation. Our results suggest that is well tolerated for experiencing moderateto-severe intensity.