Fentanyl Pectin Nasal Spray Versus Oral Morphine in Doses Proportional to the Basal Opioid Regimen for the Management of Breakthrough Cancer Pain: A Comparative Study.

摘要: Abstract Context Fentanyl products have shown superiority over oral opioids for the management of breakthrough cancer pain (BTcP). However, these studies did not use an appropriate patient selection, and drugs been compared using a different rationale. Objectives The aim this randomized, crossover, controlled study was to compare efficacy safety fentanyl pectin nasal spray (FPNS) morphine (OM), given in doses proportional opioid daily doses. Methods Cancer patients with receiving ≥60 mg OM equivalents/day presenting ≤3 episodes BTcP/day were included. Patients received, crossover manner, FPNS or at regimen four consecutive BTcP. Pain intensity measured before (T0), 15 (T15), 30 minutes (T30) after drugs. Results A total 167 treated, 82 FNPS 85 OM. statistical difference between two groups observed T15, but T30 ( P  = 0.018  = 0.204, respectively). In greater number treated FPNS, there decrease ≥33% comparison (76.5% vs. 32.8%, 89% 54.9%, Similar differences found ≥50% (52.3% 11.4%, 75% 45.8%, highly significant T15  = 0.019). No severe adverse effects drug administration observed. Conclusion When used basal regimen, showed superior analgesic effect Only minor both medications.