Multiple effectiveness aspects of tapentadol for moderate–severe cancer-pain treatment: an observational prospective study

Abstract

BackgroundPrevious studies have shown the efficacy of tapentadol (TP) for chronic cancer pain. We evaluated multiple effectiveness aspects of TP prolonged release on moderate–severe cancer-related pain, neuropathic pain (NeP), patient satisfaction, and quality of life.MethodsAn observational prospective study was conducted on 80 cancer patients. Opioid-naïve patients received a starting dose of prolonged-release TP 50 mg twice daily, and opioid-experienced patients were switched to TP, not to exceed 500 mg/day. Treatment response was evaluated at 3, 6, 30–40, and 60–70 days through response rate, numeric rating-scale scoring, survival analysis (time to event for response), pain-intensity difference, TP escalation-index percentage, and effects on NeP. The drug-sparing effect on concomitant therapies was evaluated.ResultsSeventy of 80 patients (88%) were responders to treatment (95% CI 78%–94%). Compared to T0, pain-intensity reductions were statistically significant for all intervals (P<0.01), with better results at T3/T4. NeP was significantly reduced at T4 (P<0.01). The probability of response was low at the initial stages and increased during the study. Pain-intensity differences decreased during the study, though without significance. Two patients (2.5%) left the study for TP-induced side effects. A significant improvement in quality of life was observed after 30–40 days (P<0.01). The majority of patients were “satisfied”, “very satisfied”, or “extremely satisfied” (T3–T4).ConclusionTP was effective in terms of drug-sparing effect, response rate, TP escalation-index percentage, and NeP management. By comparing data from the survival analysis with the response rate and time to response (numeric rating scale from T0 to T4), we found that although TP induced a quick response, a longer period of therapy and higher doses were needed to improve the positive result.

Tapentadol is effective in the management of moderate-to-severe cancer-related pain in opioid-naïve and opioid-tolerant patients: a retrospective study

“…All patients with nociceptive pain and more than 90% of patients with neuropathic pain or mixed pain were responders. These findings highlight tapentadol’s effectiveness not only for cancer-related nociceptive pain, but also neuropathic pain and the results are mirrored in other studies [ 21 , 24 , 30 – 32 ].…”

“…We acknowledge that we are unable to draw conclusive statements regarding tapentadol's safety as opioid-induced adverse effects extend beyond nausea and vomiting. Nevertheless, published literature have demonstrated the acceptable safety and tolerability profile of tapentadol in patients with cancer-related pain [21,24,[30][31][32].…”

“…We acknowledge that we are unable to draw conclusive statements regarding tapentadol’s safety as opioid-induced adverse effects extend beyond nausea and vomiting. Nevertheless, published literature have demonstrated the acceptable safety and tolerability profile of tapentadol in patients with cancer-related pain [ 21 , 24 , 30 – 32 ]. Besides, tapentadol has also demonstrated better gastrointestinal tolerability due to its dual mechanism of action and weaker affinity for the mu-opioid receptor compared to other full mu-opioid receptor agonists [ 19 , 22 ].…”

<p>Tapentadol in the management of cancer pain: current evidence and future perspectives</p>

“…Finally, Cascella et al28 have recently published the results of an observational prospective study in 80 cancer patients, either opioid-naive or pretreated. In total, 70 out of 80 patients (88%) were responders.…”

<p>Toward more focused multimodal and multidisciplinary approaches for pain management in Parkinson’s disease</p>

“…A clinical report indicated that in a patient with PD it induced bradykinesia and rigidity postoperatively after deep brain stimulation 49. Tapentadol is a molecule characterized by a dual mechanism by acting on the MORs and through inhibition of the reuptake of noradrenaline, thereby, increasing endogenous modulating activity 50. Despite its potential efficacy, there are no data on PRP.…”