The Efficacy of Fentanyl Transdermal Patch as the First-Line Medicine for the Conservative Treatment of Osteoporotic Compression Fracture

Choi, Jae-Hyeog; Kang, Hui; Park, Jin Hoon; Gu, Bon Sub; Jung, Seung Mun; Oh, Se Hyun

doi:10.13004/kjnt.2017.13.2.130

Cited by 2 publications

(3 citation statements)

References 30 publications

(53 reference statements)

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“…Transdermal fentanyl has some advantages in the management of cancer pain, such as very long half-life35 and much fewer opioid-related gastrointestinal side effects, such as nausea, vomiting and constipation 36–38. Fentanyl has been reported to be used in the treatment of patients with chronic non-cancer pain such as rheumatoid arthritis, osteoporosis and postherpetic neuralgia 39 40…”

Section: Discussionmentioning

confidence: 99%

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Consumption trends and prescription patterns of opioids from 2011 to 2016: a survey in a Chinese city

Liu

Luo

Dai³

et al. 2019

BMJ Open

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ObjectiveOpioid consumption in China has been very less and has varied widely since 1995. The representatively high level of consumption in Mainland China has never been reported. Our aim was to describe the consumption trends and prescription patterns of opioids in Nanjing, a highly developed city of Mainland China, and compare the results with selected worldwide regions.MethodsApplication data of opioids in 2011–2016 were extracted from the Jiangsu Medicine Information Institute. Six opioids were included. Consumption was expressed in terms of defined daily doses (DDDs), morphine equivalents (MEs) and expenditure. The correlation between consumption of opioids and gross domestic product (GDP), Human Development Index (HDI) and cancer incidence was analysed by Pearson’s correlation test.ResultsDDDs, expenditure and MEs of opioids were, respectively, 256.04, $599.24 and 13.07 g in 2011, and increased to 361.27, $1041.79 and 18.09 g in 2016. DDDs in Nanjing were 2.80-fold that in Mainland China, 1.42-fold that in East and South-East Asia, but only equivalent to 8.89% of the worldwide average level. From 2011 to 2016, the consumption had a linear correlation with GDP, HDI and cancer incidence (p<0.05). However, DDDs varied greatly in countries with similar GDP or HDI. Within 45 Asian countries, the GDP only contributed to 10.47% of change in DDDs, while the HDI contributed to 20.32%. Consumption of non-intravenous opioids or strong opioids always comprised majority of the total consumption. The opioids prescribed predominantly were fentanyl, oxycodone and morphine. Fentanyl and oxycodone account for most of the increase in consumption.ConclusionOpioid consumption has increased >40% from 2011 to 2016, with consumption of fentanyl and oxycodone accounting for most of that increase. The consumption in Nanjing was higher than the average Chinese level, but lower than the global average. An increase in pain control services might be needed, but this need should be highly regulated.

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Section: Discussionmentioning

confidence: 99%

“… 36–38 Fentanyl has been reported to be used in the treatment of patients with chronic non-cancer pain such as rheumatoid arthritis, osteoporosis and postherpetic neuralgia. 39 40 …”

Section: Discussionmentioning

confidence: 99%

Consumption trends and prescription patterns of opioids from 2011 to 2016: a survey in a Chinese city

Liu

Luo

Dai³

et al. 2019

BMJ Open

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“…This study compared the clinical and radiologic outcomes of PVP and conservative therapy using transdermal fentanyl patches (TFPs) in patients with OVCFs [2].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Vertebroplasty versus Conservative Treatment Using a Transdermal Fentanyl Patch for Osteoporotic Vertebral Compression Fractures

Lee

et al. 2019

J Korean Neurosurg Soc

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Objective Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs. Methods Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures. Results Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months. Conclusion We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.

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The Efficacy of Fentanyl Transdermal Patch as the First-Line Medicine for the Conservative Treatment of Osteoporotic Compression Fracture

Cited by 2 publications

References 30 publications

Consumption trends and prescription patterns of opioids from 2011 to 2016: a survey in a Chinese city

Consumption trends and prescription patterns of opioids from 2011 to 2016: a survey in a Chinese city

Percutaneous Vertebroplasty versus Conservative Treatment Using a Transdermal Fentanyl Patch for Osteoporotic Vertebral Compression Fractures

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