Systematic Review of Adverse Events of Buprenorphine Patch Versus Fentanyl Patch in Patients with Chronic Moderate-To-Severe Pain

Abstract

SUMMARY This systematic review compares convenience of administration, adverse events and tolerability of buprenorphine patch with fentanyl patch in patients with chronic pain. Methods of quantitative and qualitative research were combined. Seventeen databases were searched up to December 2010. A total of 49 unique trials (56 publications) were included. Patients regarded the use of patches, both transdermal buprenorphine and fentanyl, as easy and convenient. Compared with buprenorphine patch, fentanyl can cause more cases of constipation and could lead to a higher number of serious adverse events. There were no differences between buprenorphine patch and fentanyl patch regarding dizziness, somnolence, nausea and treatment discontinuation. Overall, transdermal administration of buprenorphine and fentanyl can be seen as an alternative pathway for delivering these drugs. Use of transdermal buprenorphine might be favorable in certain groups of patients, such as renally impaired, elderly and immunosuppressed patients.

The effectiveness of buprenorphine for treating cancer pain: an abridged Cochrane review

“…Given the absence of meta-analyses and the resultant narrative summaries of the results of the included studies, it is perhaps unsurprising that they tend to be in agreement in general with other systematic reviews conducted on different but overlapping questions (eg, the role of transdermal buprenorphine in managing severe cancer pain;40 the adverse effects of transdermal opioids compared with long-acting morphine for moderate-severe cancer pain;41 the use of transdermal opioids as front-line treatment for moderate-severe cancer pain;42 the adverse events of transdermal buprenorphine and fentanyl for chronic moderate-severe pain43). This is because their conclusions regarding buprenorphine are based on equally limited evidence.…”

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