Efficacy of Oral Tapentadol IR for Management of Moderate to Severe Cancer Pain in Patients Presenting in Oncology Ward at JPMC, Karachi

Abstract

Objective: To assess the efficacy and determine an effective dosing range of oral tapentadol immediate-release (IR) for managing chronic, moderate-to-severe pain in cancer patients in Pakistan, where extended-release formulations are not readily available.

Methodology: This dose-response study was conducted at the Department of Medical Oncology, JPMC, Karachi. Forty-five patients were given 75 mg BID of oral tapentadol IR and the medication was titrated as necessary to achieve optimum analgesic effects. Pain before and after one week of commencing the medication was assessed by an 11-point Numeric Rating Scale. Patient satisfaction, adverse effects and dosage required to achieve adequate analgesia was noted. Data was analyzed using IBM SPSS version 23.

Results: There was a significant decrease in the NRS score (p <0.005), from a mean score of 7.86 (SD 1.71) at the commencement of the study period to 3.14 (SD 2.86) after one week of oral tapentadol therapy. Although the dosage increased significantly over the study period, the extent of pain relief did not differ significantly across the different dosage groups (p =0.23). A majority of patients (65%; n=23) reported no adverse effects. No relationship between the level of pain reduction and gender (p =0.28), cancer type (p =0.68), or previous analgesic use (p =0.096) were found.   

Conclusion: A starting dose of 75 mg BID of tapentadol IR led to a significant pain reduction in cancer patients with chronic pain in the Pakistani population, regardless of previous analgesic intake or cancer type.