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

Abstract

Purpose Tapentadol is a dual-acting mu-opioid receptor agonist and noradrenaline reuptake inhibitor with non-inferior analgesic efficacy to oxycodone and better gastrointestinal tolerability than full mu-opioid receptor agonists. Tapentadol is approved for cancer pain in Japan; however, real-world evidence on tapentadol’s effectiveness and safety for cancer-related pain in Japan is limited. Methods This retrospective study evaluated the effectiveness, safety, and tolerability of tapentadol (by patient type—opioid-naïve and opioid-tolerant) in 84 patients with moderate-to-severe cancer pain at Ichikawa General Hospital between September 2014 and August 2016. Results Almost 93% of patients achieved clinically relevant pain relief within 4 days (median). Over 90% of patients with neuropathic pain or mixed pain and all patients with nociceptive pain were responders. Pain intensity significantly decreased from baseline through to the end of maintenance period in opioid-naïve and opioid-tolerant patients. No patients discontinued tapentadol due to serious adverse events. No opioid-naïve patients experienced nausea or vomiting during tapentadol treatment. Only three opioid-tolerant patients experienced nausea which was considered to be related to tapentadol. Conclusion Tapentadol is effective and well tolerated in opioid-naïve and opioid-tolerant patients with cancer pain of varying pathophysiology, including those with nociceptive and/or neuropathic components. Tapentadol may be considered for first-line use in moderate-to-severe cancer-related pain.

Tapentadol for the management of cancer pain in adults: an update

“…However, three opioidtolerant patients experienced tapentadol-related nausea. There were no discontinuations due to serious adverse events [29].…”

“…A retrospective single-center study in 84 Japanese patients with moderate to severe cancer pain evaluated the effectiveness, safety, and tolerability of tapentadol [29]. 93% greater than or equal to 50% reduction in NRS score from baseline.…”

Treatment of Neuropathic Pain Directly Due to Cancer: An Update

“…However, to date, there is still only modest evidence about the effectiveness of tramadol in NCP [54]. Tapentadol is a dual-acting µ-opioid receptor agonist and noradrenaline reuptake inhibitor, and its use has been suggested also for NCP, especially for cases in which an immediate dose adjustment is required or in patients at high risk for adverse effects [55,56].…”

New analgesics in cancer pain

“…Studies have shown it is effective in managing moderate–severe cancer pain; in an observational prospective study, 88% ( n = 80) were classed as responders maintaining a score on a numerical rating scale (NRS) of 3 or less with significant improvements seen in pain intensity ( P < 0.01) and neuropathic pain ( P < 0.01) [15]. A 2020 retrospective single centre study in moderate-to-severe cancer pain ( n = 84) found clinically relevant pain relief demonstrated by a 50% reduction in NRS was achieved in both opioid-tolerant and opioid-naïve patients (94.5 and 89.7%, respectively) within a median of 3 days [16 ▪ ].…”