Integrated strategies for the successful management of breakthrough cancer pain

Current Opinion in Supportive and Palliative Care

Volumn 5, Issue 1, 2011, Pages 8-14

  Dickman, Andrew ^a  

^a Marie Curie Palliative Care Institute   (United Kingdom)

Author keywords

Breakthrough cancer pain; Fentanyl; Risk management

Indexed keywords

FENTANYL; NARCOTIC ANALGESIC AGENT;

ADULT; AGED; ARTICLE; BREAST TUMOR; DRUG COMBINATION; FEMALE; HUMAN; NEOPLASM; OVARY TUMOR; PAIN; PAIN ASSESSMENT; QUALITY OF LIFE; RISK MANAGEMENT;

ADULT; AGED; ANALGESICS, OPIOID; BREAST NEOPLASMS; DRUG THERAPY, COMBINATION; FEMALE; FENTANYL; HUMANS; NEOPLASMS; OVARIAN NEOPLASMS; PAIN; PAIN MEASUREMENT; QUALITY OF LIFE; RISK MANAGEMENT;

EID: 79954546802     PISSN: 17514258     EISSN: 17514266     Source Type: Journal    
DOI: 10.1097/SPC.0b013e3283434515     Document Type: Article

References (33)

1. Zeppetella G, O'Doherty CA, Collins S. Prevalence and characteristics of breakthrough pain in cancer patients admitted to a hospice. J Pain Symptom Manage 2000; 20:87-92.
2. Payne R. Recognition and diagnosis of breakthrough pain. Pain Med 2007; 8:s3-s7. (Pubitemid 46128735)
3. Davies AN, Dickman A, Reid C, et al. The management of cancer-related breakthrough pain: recommendations of a task group of the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland. Eur J Pain 2009; 13:331-338. These are up-to-date, evidence-based, practical, clinical guidelines on the management of BTcP in adults produced by an independent, multiprofessional task force, which also include a clear definition of, diagnostic criteria for BTcP.
4. Breivik H, Cherny N, Collett B, et al. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol 2009; 20:1420-1433.
5. Soden K, Ali S, Alloway L, et al. How do nurses assess and manage breakthrough pain in specialist palliative care inpatient units? A multicentre study. Palliat Med 2010; 24:294-298.
6. Zeppetella G. Dynamics of breakthrough pain vs. pharmacokinetics of oral morphine: implications for management. Eur J Cancer Care 2009; 18:331-337.
7. Davies AN. Cancer-related breakthrough pain. Br J Hosp Med 2006; 67:414-416. (Pubitemid 44238091)
8. Dickman A. Basics of managing breakthrough cancer pain. Pharm J 2009; 283:213-216.
9. Zeppetella G. Impact and management of breakthrough pain in cancer. Curr Opin Support Palliat Care 2009; 3:1-6.
10. American Pain Foundation. Breakthrough cancer pain survey fact sheet. www.painfoundation.org. [Accessed March 2010] This survey, commissioned by the American Pain Foundation, is the first to explore the impact that BTcP has on a patient's quality of life, medical treatment and finances and reports that, for the majority of patients who have experienced BTcP, it is one of the most challenging aspects of having cancer.
11. Davies A. General principles of management. In: Davies A, editor. Cancerrelated breakthrough pain. Oxford: Oxford University Press; 2006. pp. 31-42.
12. Jacobsen R, Sjøgren P, Møldrup C, et al. Physician-related barriers to cancer pain management with opioid analgesics: a systematic review. J Opioid Manag 2007; 3:207-214. (Pubitemid 47611012)
13. Zeppetella G. Opioids for cancer breakthrough pain: a pilot study reporting patient assessment of time to meaningful pain relief. J Pain Symptom Manage 2008; 35:563-567.
14. Jacobsen R, Møldrup C, Christrup L, et al. Patient-related barriers to cancer pain management: a systematic exploratory review. Scand J Caring Sci 2009; 23:190-208.
15. Davies AN, Vriens J, Kennett A, et al. An observational study of oncology patients' utilisation of breakthrough pain medication. J Pain Symptom Manage 2008; 35:406-411.
16. Portenoy RK, Taylor D, Messina J, et al. A randomized, placebo-controlled study of fentanyl buccal tablet for breakthrough pain in opioid-treated patients with cancer. Clin J Pain 2006; 22:805-811. This pivotal study established the efficacy and tolerability of fentanyl buccal tabletfor the management of BTcP in opioid-tolerant patients. (Pubitemid 44627444)
17. Slatkin NE, Xie F, Messina J, et al. Fentanyl buccal tablet for relief of breakthrough pain in opioid-tolerant patients with cancer-related chronic pain. J Support Oncol 2007; 5:327-334. (Pubitemid 350055013)
18. Weinstein SM, Messina J, Xie F. Fentanyl buccal tablet for the treatment of breakthrough pain in opioid-tolerant patients with chronic cancer pain. A long-term, open-label safety study. Cancer 2009; 115:2571-2579. This study was the first to follow a large patient population with chronic cancer pain for 12months or more in the evaluation of fentanyl products in the management of BTcP. Data show that patients favour these agents compared with their previous BTcP medication and fentanyl buccal tablet has a favourable safety profile.
19. Rauck RL, Tark M, Reyes E, et al. Efficacy and long-term tolerability of sublingual fentanyl orally disintegrating tablet in the treatment of breakthrough cancer pain. Curr Med Res Opin 2009; 25:2877-2885. This study evaluates the efficacy and long-term tolerability of a sublingual formulation of fentanyl for the treatment of BTcP in opioid-tolerant patients with cancer.
20. Kress HG, Orońska A, Kaczmarek Z, et al. Efficacy and tolerability of intranasal fentanyl spray 50 to 200 microg for breakthrough pain in patients with cancer: a phase III, multinational, randomized, double-blind, placebo-controlled, crossover trial with a 10-month, open-label extension treatment period. Clin Ther 2009; 31:1177-1191.This study investigates the efficacy and long-term tolerability of intranasal fentanyl spray in the treatment of BTcP in opioid-tolerant patients.
21. Mercadante S, Radbruch l, Davies A, et al. A comparison of intranasal fentanyl spray with oral transmucosal fentanyl citrate for the treatment of breakthrough cancer pain: an open-label, randomised, crossover trial. Curr Med Res Opin 2009; 25:2805-2815.This study evaluates the efficacy of intranasal fentanyl spray compared with oral transmucosal fentanyl citrate for the relief of cancer-related BTcP.
22. Portenoy RK, Burton AW, Gabrail N, Taylor D. A multicenter, placebocontrolled, double-blind, multiple-crossover study of Fentanyl Pectin Nasal Spray (FPNS) in the treatment of breakthrough cancer pain. Pain 2010; 151:617-624.This pivotal clinical study demonstrates that fentanyl pectin nasal spray provides a greater reduction in pain compared with oral morphine and is well tolerated in patients experiencing BTcP.
23. Christie JM, Simmonds M, Patt R, et al. Dose-titration, multicenter study of oral transmucosal fentanyl citrate for the treatment of breakthrough pain in cancer patients using transdermal fentanyl for persistent pain. J Clin Oncol 1998; 16:3238-3245. (Pubitemid 28481617)
24. Portenoy RK, Payne R, Coluzzi P, et al. Oral transmucosal fentanyl citrate (OTFC) for the treatment of breakthrough pain in cancer patients: a controlled dose titration study. Pain 1999; 79:303-312. (Pubitemid 29076765)
25. Farrar JT, Cleary J, Rauck R, et al. Oral transmucosal fentanyl citrate: randomized, double-blinded, placebo-controlled trial for treatment of breakthrough pain in cancer patients. J Natl Cancer Inst 1998; 90:611-616. (Pubitemid 28204805)
26. Coluzzi PH, Schwartzberg L, Conroy JD, et al. Breakthrough cancer pain: a randomized trial comparing oral transmucosal fentanyl citrate (OTFC) and morphine sulfate immediate release (MSIR). Pain 2001; 91:123-130. (Pubitemid 32274181)
27. Passik SD, Squire P. Current risk assessment and management paradigms: snapshots in the life of the pain specialist. Pain Med 2009; 10 (Suppl 2): S101-S114. This article offers practical advice on risk management strategies to clinicians who choose to prescribe opioid analgesics through the use of a series of case presentations.
28. Myers J, Shetty N. Going beyond efficacy: strategies for cancer pain management. Curr Oncol 2008; 15 (Suppl 1):S41-S49.
29. Ives TJ, Chelminski PR, Hammett-Stabler CA, et al. Predictors of opioid misuse in patients with chronic pain: a prospective cohort study. BMC Health Serv Res 2006; 6:1-10.
30. Miaskowski C. The use of risk-management approaches to protect patients with cancer-related pain and their healthcare providers. Oncol Nurs Forum 2008; 35 (Suppl):20-24.
31. Hanks GW, Nugent M, Higgs CMB, et al. Oral transmucosal fentanyl citrate in the management of breakthrough pain in cancer: an open, multicentre, dosetitration and long-term use study. Palliat Med 2004; 18:698-704. (Pubitemid 39654548)
32. Darwish M, Kirby M, Jiang JG. Effect of buccal dwell time on the pharmacokinetic profile of fentanyl buccal tablet. Expert Opin Pharmacother 2007; 8:2011-2016. (Pubitemid 47514454)
33. Darwish M, Kirby M, Jiang JG, et al. Bioequivalence following buccal and sublingual placement of fentanyl buccal tablet 400 mg in healthy subjects. Clin Drug Invest 2008; 28:1-7. (Pubitemid 350274395)