PMID- 31177479
OWN - NLM
STAT- MEDLINE
DCOM- 20200130
LR  - 20200225
IS  - 1179-6901 (Electronic)
IS  - 1174-5886 (Print)
IS  - 1174-5886 (Linking)
VI  - 19
IP  - 3
DP  - 2019 Sep
TI  - Effects of Age Among Elderly Cancer Patients on Breakthrough Pain Management with 
      Sublingual Fentanyl Tablets.
PG  - 247-254
LID - 10.1007/s40268-019-0276-x [doi]
AB  - 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.
FAU - Guitart, Jordi
AU  - Guitart J
AD  - Department of Anesthesiology, Hospital Plato, C/Plato 21, 08006, Barcelona, 
      Spain. jordi.guitart@hospitalplato.com.
FAU - Vargas, Maria Isabel
AU  - Vargas MI
AD  - Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
FAU - De Sanctis, Vicente
AU  - De Sanctis V
AD  - Pain Unit, Department of Anesthesiology, Hospital Universitari Sagrat Cor, 
      Barcelona, Spain.
FAU - Folch, Jordi
AU  - Folch J
AD  - Department of Anesthesiology, Hospital Plato, C/Plato 21, 08006, Barcelona, 
      Spain.
FAU - Salazar, Rafael
AU  - Salazar R
AD  - Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain.
FAU - Fuentes, Jose
AU  - Fuentes J
AD  - Department of Anesthesiology, Pius Hospital de Valls, Tarragona, Spain.
FAU - Coma, Joan
AU  - Coma J
AD  - Department of Anesthesiology, Hospital General de l'Hospitalet, Barcelona, Spain.
FAU - Ferreras, Julia
AU  - Ferreras J
AD  - Pain Unit, Department of Anesthesiology, Hospital Residencia Sant Camil, 
      Barcelona, Spain.
FAU - Moya, Jordi
AU  - Moya J
AD  - Pain Unit, Department of Anesthesiology, Hospital Mateu Orfila, Minorca, Spain.
FAU - Tomas, Albert
AU  - Tomas A
AD  - Pain Unit, Department of Anesthesiology, Fundacio Hospital Sant Bernabe, 
      Barcelona, Spain.
FAU - Estivill, Pere
AU  - Estivill P
AD  - Department of Anesthesiology, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
FAU - Rodelas, Francisco
AU  - Rodelas F
AD  - Department of Anesthesiology, Hospital Comarcal d'Inca, Palma de Mallorca, Spain.
FAU - Jimenez, Antonio Javier
AU  - Jimenez AJ
AD  - Kyowa Kirin Farmaceutica SLU, Madrid, Spain.
FAU - Sanz, Almudena
AU  - Sanz A
AD  - Kyowa Kirin Farmaceutica SLU, Madrid, Spain.
LA  - eng
PT  - Journal Article
PL  - New Zealand
TA  - Drugs R D
JT  - Drugs in R&D
JID - 100883647
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Tablets)
RN  - UF599785JZ (Fentanyl)
SB  - IM
MH  - Administration, Sublingual
MH  - Aged
MH  - Analgesics, Opioid/*administration & dosage
MH  - Breakthrough Pain/*drug therapy
MH  - Cancer Pain/*drug therapy
MH  - Female
MH  - Fentanyl/*administration & dosage
MH  - Humans
MH  - Male
MH  - Neoplasms/*complications
MH  - Pain Management/methods
MH  - Tablets/*administration & dosage
PMC - PMC6738361
COIS- Antonio Javier Jimenez and Almudena Sanz are employees of Kyowa Kirin 
      Farmaceutica SLU. The authors declared they have no further competing interests.
EDAT- 2019/06/10 06:00
MHDA- 2020/01/31 06:00
PMCR- 2019/06/08
CRDT- 2019/06/10 06:00
PHST- 2019/06/10 06:00 [pubmed]
PHST- 2020/01/31 06:00 [medline]
PHST- 2019/06/10 06:00 [entrez]
PHST- 2019/06/08 00:00 [pmc-release]
AID - 10.1007/s40268-019-0276-x [pii]
AID - 276 [pii]
AID - 10.1007/s40268-019-0276-x [doi]
PST - ppublish
SO  - Drugs R D. 2019 Sep;19(3):247-254. doi: 10.1007/s40268-019-0276-x.