section name header

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A Cochrane review [Abstract] 1 [withdrawn from publication] included 4 studies with a total of 393 subjects.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 WITHDRAWN: Opioids for the management of breakthrough pain in cancer patients.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