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Evidence summaries

Fentanyl for Breakthrough (Episodic) Pain in Cancer Patients

Oral transmucosal fentanyl citrate is effective in the management of breakthrough pain in patients with cancer. Level of evidence: "A"

A Cochrane review [Abstract] 1 [withdrawn from publication] included 4 studies with a total of 393 subjects. All concerned oral transmucosal fentanyl citrate (OTFC). OTFC was superior to placebo, normal release morphine, and previous rescue medication with a weighted mean difference (WMD) of -0.68 (95% CI -1.03 to -0.34) for pain intensity at 15 mins and WMD -0.91 (95% CI -1.23 to -0.59) for pain intensity at 30 mins. OTFC was superior in providing pain relief at 15 mins, WMD 0.54 (95% CI 0.40 to 0.69) and 30 mins WMD 0.61 (95% CI 0.47 to 0.75); and superior global performance (compared to previous rescue medication and placebo) WMD 0.76 (95% CI 0.58 to 0.95). No trials were found for other opioids.

References

  • Zeppetella G, Davies AN. WITHDRAWN: Opioids for the management of breakthrough pain in cancer patients. Cochrane Database Syst Rev 2015;(8):CD004311. [PubMed]

Primary/Secondary Keywords