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Tapentadol Prolonged Release Improves Analgesia, Functional Impairment, and Quality of Life in Patients With Chronic Pain Who Have Previously Received Oxycodone/Naloxone

Kern K-U, Krings D, and Waldmann-Rex S

Background: This subgroup analysis of a prospective, non-interventional study involving general practitioners/ internists evaluated tapentadol prolonged release (PR) in patients who previously received oxycodone/naloxone.

Methods: This non-interventional study, which had a 3-month observation period, included 5002 patients. Data from a subgroup of patients previously treated with oxycodone/naloxone (n=382) were included in this analysis.

Results: Back pain was the most common cause of pain, and mixed pain (nociceptive and neuropathic) predominated. Oxycodone/naloxone pretreatment was most commonly combined with non-opioids (78.3%) or coanalgesics (56.0%). The most common reasons for starting tapentadol PR were insufficient analgesia (87.4%) and impaired quality of life (70.2%). Switching to tapentadol PR (final average daily dose, 252.9 mg) resulted in a mean pain reduction of 3.41 points on an 11-point numerical rating scale (baseline, 7.29 ± 1.40; end of observation, 3.88 ± 1.86; descriptive P value ≤ 0.001; n=373). The percentage of patients who did not require additional analgesics (i.e., those on tapentadol PR monotherapy) increased from 24.6% at the start of treatment to 33.5% at the final visit. Coanalgesic use also decreased from the start of treatment to the final visit (antidepressants: 46.6% to 39.4%; anticonvulsants: 24.6% to 15.9%). Significant improvements were achieved in pain-related functional impairment and Short Form-12 summary scores. Tapentadol PR was well tolerated.

Conclusion: Patients who previously received oxycodone/naloxone benefit from tapentadol PR therapy; clinically relevant improvements in analgesia, functionality, and quality of life were documented. Furthermore, analgesic comedication could be reduced during tapentadol PR treatment, reducing medication burden and potentially leading to improved compliance.