Journal
JOURNAL OF PAIN RESEARCH
Volume 8, Issue -, Pages 229-238Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/JPR.S83490
Keywords
tapentadol; multiple myeloma; bone; neuropathic pain; opioids
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Context: Myeloma bone disease (MBD) is a devastating complication of multiple myeloma that leads to severe pain. Objectives: The aim of this study was to evaluate the efficacy and tolerability of tapentadol prolonged release (PR) in the management of patients with MBD suffering from moderate-to-severe cancer pain. Methods: A 12-week prospective study was carried out in 25 opioid-naive MBD patients. Patients initially received twice-daily doses of tapentadol PR 50 mg. Doses were then managed to maintain adequate relief or dose-limiting toxicity. The following parameters were recorded at weekly intervals for 4 weeks, and then at weeks 8 and 12: pain, opioid-related adverse effects, use of other analgesics, DN4 (Douleur Neuropathique 4) score. Quality of life (SF-36 [36-item short-form health survey]) was measured at baseline and at final evaluation. Results: Of 25 patients, 22 completed the study. Pain intensity significantly decreased from baseline to all the week intervals (P<0.01). Quality of life significantly improved with respect to all SF-36 subscale parameters (P<0.01), and so did both the physical and mental status (P<0.01). Tapentadol PR significantly reduced DN4 mean value (P<0.01) and the number of patients with neuropathic component (DN4 >= 4) (P<0.01). After 8 weeks of treatment, all patients were negative for the DN4 score. Tapentadol PR was well tolerated, and the use of other analgesics was reduced during the study period. Conclusion: Tapentadol PR started in doses of 100 mg/day was effective and well tolerated in opioid-naive MBD patients with moderate-to-severe pain. Tapentadol PR can be considered a first-choice opioid in cancer patients suffering from mixed pain with a neuropathic component.
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