Effect of Dose Escalation with Single Opioid, Fentanyl Matrix in Patients Not Controlling Cancer Pain: A Multicenter, Prospective, Observational Study in Korea

Title
Effect of Dose Escalation with Single Opioid, Fentanyl Matrix in Patients Not Controlling Cancer Pain: A Multicenter, Prospective, Observational Study in Korea
Author(s)
이경희고성애이규택[이규택]류현모[류현모]박승우[박승우]남성현[남성현]류현모[류현모]
Keywords
TRANSDERMAL FENTANYL; CARE; VALIDATION; EFFICACY; RELIEF; HOME
Issue Date
201312
Publisher
KOREAN CANCER ASSOCIATION
Citation
CANCER RESEARCH AND TREATMENT, v.45, no.4, pp.263 - 269
Abstract
Purpose End-of-dose failure (EOD) is a clinically common observation and many cancer patients increase the frequency of opioid administration. Fentanyl matrix use is known to be effective in patients with chronic cancer pain. To measure the effectiveness of increase in a single dose of fentanyl matrix in patients whose pain was not controlled sufficiently, we perform this study. Materials and Methods A multi-center, open-label, prospective, observational study was conducted in 30 hospitals in Korea, between August and December 2008. Results A total of 452 patients were enrolled; 404 patients completed the study. The mean pain intensity decreased from 5.27 at the first visit to 3.37 at the end of the trial. There was a significant difference in pain intensity (p < 0.001) between the first and last visits. The percentage of pain intensity difference was 30.1%. The prevalence of EOD at the first visit was 73% from the 452 enrolled patients. After the use of fentanyl patch, EOD decreased from 73% to 56%. Pain intensity of patients experiencing EOD was 5.64 at the baseline compared to 4.27 in patients without EOD. On final visit, pain intensity in patients with and without EOD was 4.02 and 2.54, respectively. The observed adverse events were mainly nausea, asthenia, constipation and diarrhea. Conclusion This study demonstrated that increasing dose of fentanyl patch decreased pain intensity and decreased the rate of patients experiencing EOD. Thus, fentanyl patch may be an effective modality in cancer patients whose pain was previously not controlled sufficiently; the side effects were as could be expected with an opioid.
URI
http://hdl.handle.net/YU.REPOSITORY/28025http://dx.doi.org/10.4143/crt.2013.45.4.263
ISSN
1598-2998
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의과대학 > 내과학교실 > Articles
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