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Guitart-Vela J, Magrone Á, González G, Folch J. Effectiveness and Safety of Sublingual Fentanyl in the Treatment of Breakthrough Cancer Pain in Older Patients with Cancer: Results from a Retrospective Observational Study. J Pain Palliat Care Pharmacother 2024:1-12. [PMID: 39115710 DOI: 10.1080/15360288.2024.2385680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 06/03/2024] [Accepted: 07/20/2024] [Indexed: 08/10/2024]
Abstract
The study assessed sublingual fentanyl citrate (SFC) effectiveness and safety for breakthrough cancer pain (BtCP) in older patients. A multicenter, retrospective, observational study was conducted in three subgroups of cancer patients aged over 65 years with BtCP. The reports were collected by 20 oncologists across 12 hospitals. The primary goal was to measure changes in BtCP intensity with SFC treatment over 30 days; secondary objectives included pain relief onset and adverse events. A total of 127 patients with long-term cancer (mean: 3.3 years) were recruited. All of them had BtCP, mostly of mixed origin (62.5%). A significantly lower dose was needed in the high-age group at the final visit compared to baseline (212.90 ± 200.45 mcg vs. 206 ± 167.08 mcg; p = 0.000). Pain intensities at the beginning of the flare and at 30 min after SFC administration were significantly lower when the last and first visits were compared (1.9 vs. 2.3, p = 0.000; and 6.2 vs. 6.8 p = 0.006, respectively). The onset of analgesia was significantly more rapid for half of the patients ≥75 years, compared with 65-69 and 70-74 age groups. SFC appears then to be effective, well-tolerated, and safe to treat BtCP in older cancer patients.
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Affiliation(s)
| | | | | | - Jordi Folch
- Servicio de Patología del Dolor, Hospital Plató, Barcelona, Spain
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2
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Cuomo A. Fentanyl in cancer pain management: avoiding hasty judgments and discerning its potential benefits. Drugs Context 2023; 12:2023-10-2. [PMID: 38148830 PMCID: PMC10751104 DOI: 10.7573/dic.2023-10-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/14/2023] [Indexed: 12/28/2023] Open
Abstract
Cancer pain is an important challenge in treatment and requires a rapid onset of action for its control. In particular, breakthrough cancer pain (BTcP) should be adequately controlled with a stable dose of a short-acting oral opioid. Fentanyl is a synthetic, highly selective opioid with many advantageous chemical properties, including high lipophilicity and distinct pharmacokinetic properties. It is recommended for pain management in a variety of settings, including acute pain, chronic pain and BTcP. To date, its variously designed formulations allow non-invasive administration; amongst others, sublingual fentanyl has proven useful in the management of BTcP and in improving the quality of life of patients with cancer. This review provides an update on the management of BTcP with fentanyl, with consideration of safety, as it remains an important tool in the treatment of cancer pain.
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Affiliation(s)
- Arturo Cuomo
- Istituto Nazionale dei Tumori, IRCCS Fondazione G. Pascale, Naples,
Italy
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Kang JH, Koh SJ, Oh SY, Kim RB, Shin SH, Lee YG, Kim BS, Ryoo HM, Yoon SY, Jang JS, Oh HS, Choi YJ, Lee MH, Lee KH. Interference with daily functioning by breakthrough pain in patients with cancer. Support Care Cancer 2020; 28:5177-5183. [PMID: 32056013 DOI: 10.1007/s00520-020-05329-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/27/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the association between quality of life (QOL) and breakthrough cancer pain (BTCP) intensity in patients who met the commonly accepted definition of BTCP. METHODS This study was a subset analysis of a South Korean multicenter, non-interventional, cross-sectional, nationwide survey. Participants were recruited from March 2016 to December 2017. BTCP was defined as a controlled background pain of less than a numeric rating scale (NRS) of 3 and any flare-up pain intensity. Pain intensity data were collected using the Brief Pain Inventory (BPI), which includes an interference assessment of the affective and physical domains. Patients were categorized by BTCP intensity into mild (NRS 1-3), moderate (4-6), and severe (7-10) groups. RESULTS Of the 969 screened patients with cancer, 679 had ≤ NRS 3 background pain, of whom 438 completed the BPI. Of these 438 patients, 40, 204, and 194 were in the mild, moderate, and severe BTCP groups, respectively. The median NRS of BTCP was 6.0 (interquartile range = 5.0-8.0). Patients with moderate-severe BTCP had significantly higher interference with daily functioning (IDF) scores than did mild BTCP patients (3.3 vs. 5.7; p < 0.01). Both domains of IDF were significantly hampered proportionally by increased BTCP intensity (p < 0.001). The median total IDF scores of the no, moderate, and severe BTCP groups were 3.3, 5.0, and 6.9, respectively. Furthermore, IDF depended on BTCP intensity, duration, and frequency (p < 0.01) but not on pain type and cause. CONCLUSION An increase in BTCP intensity is likely to result in IDF, regardless of the cause or type of BTCP.
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Affiliation(s)
- Jung Hun Kang
- Department of Internal Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Su-Jin Koh
- Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Republic of Korea
| | - So Yeon Oh
- Department of Internal medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Rock Bum Kim
- Department of Preventive Medicine, Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Seong Hoon Shin
- Department of Internal Medicine, Division of Hemato-Oncology, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Yun-Gyoo Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Bong-Seog Kim
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Hun Mo Ryoo
- Department of Internal Medicine, School of Medicine, Catholic University of Daegu, Daegu, Republic of Korea
| | - So Young Yoon
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, South Korea
| | - Joung Soon Jang
- Department of Internal Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Ho-Suk Oh
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Young Jin Choi
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Moon Hee Lee
- Department of Internal Medicine, Inha University Hospital, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Kyung-Hee Lee
- Department of Internal Medicine, Yeungnam University, Daegu, Republic of Korea.
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Guitart J, Vargas MI, De Sanctis V, Folch J, Salazar R, Fuentes J, Coma J, Ferreras J, Moya J, Tomás A, Estivill P, Rodelas F, Jiménez AJ, Sanz A. Effects of Age Among Elderly Cancer Patients on Breakthrough Pain Management with Sublingual Fentanyl Tablets. Drugs R D 2019; 19:247-254. [PMID: 31177479 PMCID: PMC6738361 DOI: 10.1007/s40268-019-0276-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Sublingual fentanyl tablets (SFTs) have been shown to be a safe and effective option in controlling breakthrough cancer pain (BTcP). However, further examination is required to investigate the use of SFTs among the elderly. The aim of this study was to examine the influence of age in BTcP management with SFTs in the elderly population. Methods We performed subgroup analyses of a recently completed trial in two subsets of individuals: patients aged 65–74 years (low age group) and patients ≥ 75 years (high age group). Pain intensity (PI), onset of pain relief, frequency and duration of BTcP episodes, and adverse events (AEs) were assessed at 3, 7, 15, and 30 days. Health status instruments used were the Hospital Anxiety and Depression Scale (HADS-A and HADS-D) and the Short Form 12, version 2 (SF-12v2) questionnaire. Results Levels of PI at the end of the study improved significantly as compared with baseline in both the low and the high age groups (30.0% and 27.7% reduction, respectively). The onset of analgesia at the end of the study began in < 10 min in 85.0% of young–old subjects and in 62.5% of patients ≥ 75 years, but no significant differences were found. BTcP episodes lasted < 15 min in 75.0% of patients in the low age group and 58.3% in the high age group (p = 0.24). Most of patients in both groups experienced one to five BTcP daily episodes, at all assessment points. HADS-D decreased from 10.78 (± 4.33) to 8.21 (± 3.57) in the low age group, and from 10.96 (± 4.26) to 9.36 (± 3.35) in the high age group (p = 0.02). Significant differences in HADS-A scores from baseline to the end of the study were also observed in both subgroups (p < 0.05). Patients in the low age group had less favorable mental component summary (MCS) and physical component summary (PCS) scores than patients in the high age group. At the end of the study, 10.0% of young–old patients and 29.2% of patients aged ≥ 75 years reported AEs related to their treatment. The most commonly reported AEs included nausea, vomiting, constipation, somnolence, and skin disorders and they were generally mild to moderate in severity. Conclusions The results of this study showed that SFTs provided safe and clinically meaningful pain relief in both elderly subgroups. Clinical implications of these findings await validation in large, confirmatory studies to identify age subgroup divergences among elderly cancer patients treated with SFTs.
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Affiliation(s)
- Jordi Guitart
- Department of Anesthesiology, Hospital Plató, C/Plató 21, 08006, Barcelona, Spain.
| | - María Isabel Vargas
- Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Vicente De Sanctis
- Pain Unit, Department of Anesthesiology, Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Jordi Folch
- Department of Anesthesiology, Hospital Plató, C/Plató 21, 08006, Barcelona, Spain
| | - Rafael Salazar
- Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain
| | - José Fuentes
- Department of Anesthesiology, Pius Hospital de Valls, Tarragona, Spain
| | - Joan Coma
- Department of Anesthesiology, Hospital General de l'Hospitalet, Barcelona, Spain
| | - Julia Ferreras
- Pain Unit, Department of Anesthesiology, Hospital Residència Sant Camil, Barcelona, Spain
| | - Jordi Moya
- Pain Unit, Department of Anesthesiology, Hospital Mateu Orfila, Minorca, Spain
| | - Albert Tomás
- Pain Unit, Department of Anesthesiology, Fundació Hospital Sant Bernabé, Barcelona, Spain
| | - Pere Estivill
- Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Francisco Rodelas
- Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain
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Fujii K, Koshidaka Y, Adachi M, Takao K. Effects of chronic fentanyl administration on behavioral characteristics of mice. Neuropsychopharmacol Rep 2018; 39:17-35. [PMID: 30506634 PMCID: PMC7292323 DOI: 10.1002/npr2.12040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/10/2018] [Accepted: 10/19/2018] [Indexed: 01/16/2023] Open
Abstract
Background Fentanyl, a synthetic opioid categorized as a narcotic analgesic, has a 100‐ to 200‐fold stronger effect than most opioids, such as morphine. Fatal accidents due to chronic use and abuse of fentanyl are a worldwide social problem. One reason for the abuse of fentanyl is its psychostimulant effects that could induce behavioral changes. The effects of chronic fentanyl administration on behavior, however, are unclear. Methods Adult male C57BL/6J mice were chronically administered fentanyl (0.03 or 0.3 mg/kg/d i.p.), and various behaviors were assessed using a behavioral test battery. Results Mice chronically administered a high dose of fentanyl (0.3 mg/kg/d) exhibited decreased anxiety‐like behavior as assessed by the open field and elevated plus maze tests. On the other hand, interruption of fentanyl administration led to increased anxiety‐like behavior as observed in the light and dark transition test. The hot plate test revealed that chronic administration of fentanyl reduced pain sensitivity. High‐dose chronic fentanyl administration reduced the locomotor stimulatory effects of cocaine. The results, however, failed to reach the threshold for study‐wide statistical significance. Conclusion Chronic fentanyl administration induces some behavioral changes in mice. Although further studies are needed to clarify the underlying mechanisms of the behavioral effects of chronic fentanyl administration, our findings suggest that fentanyl is safe under properly controlled conditions. To investigate the effects of long‐term fentanyl use on brain function, adult male C57BL/6J mice were chronically administered fentanyl (0.03 or 0.3 mg/kg/d ip) and analyzed in a behavioral test battery. Chronic fentanyl administration reduced anxiety‐like behavior, pain sensitivity, and the locomotor stimulatory effects of cocaine in mice. The results, however, failed to reach the threshold for study‐wide statistical significance.![]()
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Affiliation(s)
- Kazuki Fujii
- Department of Behavioral Physiology, Graduate School of Innovative Life Science, University of Toyama, Toyama, Japan.,Life Science Research Center, University of Toyama, Toyama, Japan
| | - Yumie Koshidaka
- Life Science Research Center, University of Toyama, Toyama, Japan
| | - Mayumi Adachi
- Life Science Research Center, University of Toyama, Toyama, Japan
| | - Keizo Takao
- Department of Behavioral Physiology, Graduate School of Innovative Life Science, University of Toyama, Toyama, Japan.,Life Science Research Center, University of Toyama, Toyama, Japan
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6
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Guitart J, Vargas MI, De Sanctis V, Folch J, Salazar R, Fuentes J, Coma J, Ferreras J, Moya J, Tomás A, Estivill P, Rodelas F, Jiménez AJ, Sanz A. Efficacy and Safety of Sublingual Fentanyl Tablets in Breakthrough Cancer Pain Management According to Cancer Stage and Background Opioid Medication. Drugs R D 2018; 18:119-128. [PMID: 29572732 PMCID: PMC5995789 DOI: 10.1007/s40268-018-0231-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective Our objective was to assess the effect of sublingual fentanyl tablets (SFTs) on pain relief, quality of life, and adverse effects in patients with cancer pain, according to cancer stage and background opioid regimen. Methods Subgroup analyses from a recently completed study were performed according to cancer stage (locally advanced cancer [LAC] vs. metastatic cancer) and most frequent background opioid medication (fentanyl vs. oxycodone/naloxone). The efficacy and safety of SFTs were evaluated, recording pain intensity (PI), onset of pain relief, and adverse events (AEs). Health status was assessed with the Short Form 12, version 2 (SF-12v2) questionnaire and the Hospital Anxiety and Depression Scale (anxiety subscale [HADS-A] and depression subscale [HADS-D]). Results In total, 54 (67.5%) patients had LAC and 26 (32.5%) had metastatic cancer. The oxycodone/naloxone group included 39 patients (48.1%) and the fentanyl group 29 (35.8%). In all subgroups, pain relief was achieved within 5 min in an increasing number of individuals over time; at the end of the study, PI values decreased (PI-end: 44.4% for LAC vs. 57.9% for metastatic cancer; 44.4% for fentanyl vs. 38.6% for oxycodone/naloxone). HADS and mental component summary (MCS) SF-12v2 scores significantly improved in the LAC group (HADS-A 9.44–8.04; HADS-D 10.46–8.15; MCS 44.69–45.94) and in the fentanyl group (HADS-A 10.05–8.33; HADS-D 11.95–8.76; MCS 44.38–47.19). AEs were reported in few patients and were mostly mild. Conclusions Exploratory subgroup analyses show the efficacy and safety of SFTs for the treatment of breakthrough pain in patients with cancer, regardless of their cancer stage and background opioid medication.
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Affiliation(s)
- Jordi Guitart
- Department of Anesthesiology, Hospital Plató, C/Plató 21, 08006, Barcelona, Spain.
| | - María Isabel Vargas
- Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Vicente De Sanctis
- Pain Unit, Department of Anesthesiology, Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Jordi Folch
- Department of Anesthesiology, Hospital Plató, C/Plató 21, 08006, Barcelona, Spain
| | - Rafael Salazar
- Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain
| | - José Fuentes
- Department of Anesthesiology, Pius Hospital de Valls, Tarragona, Spain
| | - Joan Coma
- Department of Anesthesiology, Hospital General de l'Hospitalet, Barcelona, Spain
| | - Julia Ferreras
- Pain Unit, Department of Anesthesiology, Hospital Residència Sant Camil, Barcelona, Spain
| | - Jordi Moya
- Pain Unit, Department of Anesthesiology, Hospital Mateu Orfila, Menorca, Spain
| | - Albert Tomás
- Pain Unit, Department of Anesthesiology, Fundació Hospital Sant Bernabé, Barcelona, Spain
| | - Pere Estivill
- Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Francisco Rodelas
- Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain
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7
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Mücke M, Conrad R, Marinova M, Cuhls H, Elsner F, Rolke R, Radbruch L. [Dose-finding for treatment with a transdermal fentanyl patch : Titration with oral transmucosal fentanyl citrate and morphine sulfate]. Schmerz 2017; 30:560-567. [PMID: 27072143 DOI: 10.1007/s00482-016-0106-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To date, no studies investigating titration with oral transmucosal fentanyl for the dose-finding of transdermal fentanyl treatment have been published. In an open randomized study 60 patients with chronic malignant (n = 39) or nonmalignant pain (n = 21), who required opioid therapy according to step three of the guidelines of the World Health Organization (WHO), were investigated. In two groups of 30 patients each titration with immediate release morphine (IRM) or oral transmucosal fentanyl citrate (OTFC) was undertaken. For measurement purposes the Brief Pain Inventory (BPI) and Minimal Documentation System (MIDOS) were used. After a 24-h titration phase, in which patients documented the intensity of pain, nausea, and tiredness, treatment with transdermal fentanyl was evaluated over a 10-day period by means of the necessary dose adaptation (responder ≤ 1 dose adaptation; conversion formula 1:1 [OTFC group] vs 100:1 [IRM group]).The pain reduction over the first 24 h (titration phase) did not differ significantly between the groups. The number of responders (17 OTFC vs. 21 IRM) over the 10-day period did not show any difference either. In both groups there was a significant reduction in pain intensity (p < 0.001). Over the course of the study, there were significantly more drop-outs because of adverse effects in the OTFC group than in the IRM group (8 vs 1, p = 0.028).Oral transmucosal fentanyl citrate can be applied for the titration of transdermal fentanyl, but it does not show any clinically relevant advantage. For example, the risk of side effects-induced drop-outs was greater in the present study. Whether the unnecessary opioid switching to treat chronic pain and breakthrough pain is advantageous with regard to minimizing conversion errors cannot be definitively answered within the scope of this study.
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Affiliation(s)
- M Mücke
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland. .,Institut für Hausarztmedizin, Universitätsklinikum Bonn, Bonn, Deutschland.
| | - R Conrad
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Marinova
- Radiologische Klinik, Universitätsklinikum Bonn, Bonn, Deutschland
| | - H Cuhls
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland
| | - F Elsner
- Klinik für Palliativmedizin, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - R Rolke
- Klinik für Palliativmedizin, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - L Radbruch
- Klinik für Palliativmedizin, Universitätsklinikum Bonn, Bonn, Deutschland.,Zentrum für Palliativmedizin, Malteser Krankenhaus Seliger Gerhard Bonn/Rhein-Sieg, Bonn, Deutschland
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8
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Boyaka PN. Inducing Mucosal IgA: A Challenge for Vaccine Adjuvants and Delivery Systems. THE JOURNAL OF IMMUNOLOGY 2017. [PMID: 28630108 DOI: 10.4049/jimmunol.1601775] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Mucosal IgA or secretory IgA (SIgA) are structurally equipped to resist chemical degradation in the harsh environment of mucosal surfaces and enzymes of host or microbial origin. Production of SIgA is finely regulated, and distinct T-independent and T-dependent mechanisms orchestrate Ig α class switching and SIgA responses against commensal and pathogenic microbes. Most infectious pathogens enter the host via mucosal surfaces. To provide a first line of protection at these entry ports, vaccines are being developed to induce pathogen-specific SIgA in addition to systemic immunity achieved by injected vaccines. Mucosal or epicutaneous delivery of vaccines helps target the inductive sites for SIgA responses. The efficacy of such vaccines relies on the identification and/or engineering of vaccine adjuvants capable of supporting the development of SIgA alongside systemic immunity and delivery systems that improve vaccine delivery to the targeted anatomic sites and immune cells.
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Affiliation(s)
- Prosper N Boyaka
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210
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9
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Guitart J, Vargas MI, De Sanctis V, Folch J, Salazar R, Fuentes J, Coma J, Ferreras J, Moya J, Tomás A, Estivill P, Rodelas F, Jiménez AJ, Sanz A. Breakthrough Pain Management with Sublingual Fentanyl Tablets in Patients with Cancer: Age Subgroup Analysis of a Multicenter Prospective Study. Drugs R D 2017; 17:419-425. [PMID: 28744772 PMCID: PMC5629138 DOI: 10.1007/s40268-017-0198-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Breakthrough pain (BTP) management in patients with cancer is challenging, especially in the elderly. However, no studies examining the influence of age on BTP medication have been conducted. The aim of this work was to investigate the effect of sublingual fentanyl tablets (SFTs) in terms of efficacy, safety, and quality of life in two age categories. METHODS We performed age subgroup analyses (<65 and ≥65 years) from a recently completed study conducted in Spain. Pain intensity (PI), onset of pain relief, frequency and duration of BTP episodes, and adverse events (AEs) were assessed at 3, 7, 15, and 30 days. Health-status instruments used were the Short Form 12, version 2 (SF-12v2) questionnaire, and the Hospital Anxiety and Depression Scale (HADS-A and HADS-D). RESULTS Twenty-six patients were aged <65 years and 54 were aged ≥65 years. SF-12v2 scores did not enhance significantly from baseline. HADS scores and PI decreased significantly at the end of the study, particularly in younger patients (HADS-A: 19.05 vs. 14.41%; HADS-D: 21.35 vs. 18.57%; PI: 67.23 vs. 56.30%). Onset of analgesia began in 2-5 min in 63.3% of subjects aged <65 years and in 36.4% of subjects aged >65 years. Most patients experienced one to five daily episodes after 30 days, and <5% needed a treatment change. AEs were less frequently reported in older individuals (20.5 vs. 36.4%). CONCLUSION Age subgroup analyses suggest that SFTs are an effective and safe treatment for the management of BTP in cancer patients of all ages. SFTs may offer a well-tolerated and efficient option to control cancer BTP in the elderly.
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Affiliation(s)
- Jordi Guitart
- Department of Anesthesiology, Hospital Plató, C/Plató 21, 08006, Barcelona, Spain.
| | - María Isabel Vargas
- Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Vicente De Sanctis
- Pain Unit, Department of Anesthesiology, Hospital Universitari Sagrat Cor, Barcelona, Spain
| | - Jordi Folch
- Department of Anesthesiology, Hospital Plató, C/Plató 21, 08006, Barcelona, Spain
| | - Rafael Salazar
- Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain
| | - José Fuentes
- Department of Anesthesiology, Pius Hospital de Valls, Tarragona, Spain
| | - Joan Coma
- Department of Anesthesiology, Hospital General de l'Hospitalet, Barcelona, Spain
| | - Julia Ferreras
- Pain Unit, Department of Anesthesiology, Hospital Residència Sant Camil, Barcelona, Spain
| | - Jordi Moya
- Pain Unit, Department of Anesthesiology, Hospital Mateu Orfila, Menorca, Spain
| | - Albert Tomás
- Pain Unit, Department of Anesthesiology, Fundació Hospital Sant Bernabé, Barcelona, Spain
| | - Pere Estivill
- Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Francisco Rodelas
- Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain
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