Buprenorphine not a silver bullet but an opioid of choice for chronic pain

Authors

  • Mellar P. Davis, MD, FCCP, FAAHPM
  • Jeffrey Fudin, PharmD, FACCP, FASHP, FFSMB

DOI:

https://doi.org/10.5055/jom.2021.0619

Keywords:

buprenorphine, sustained-release

Abstract

-

Author Biographies

Mellar P. Davis, MD, FCCP, FAAHPM

Geisinger Medical Center, Danville Pennsylvania

Jeffrey Fudin, PharmD, FACCP, FASHP, FFSMB

Adjunct Associate Professor, Albany College of Pharmacy and Health Sciences, Albany New York; Adjunct Associate Professor, Western New England University College of Pharmacy, Springfield Massachusetts; President, Remitigate Therapeutics, Delmar New York

References

Coplan PM, Cepeda MS, Petronis KR, et al.: Postmarketing studies program to assess the risks and benefits of long-term use of extended-release/long-acting opioids among chronic pain patients. Postgrad Med. 2020; 132(1): 44-51.

Cone EJ, DePriest AZ, Gordon A, et al.: Risks and responsibilities in prescribing opioids for chronic noncancer pain, part 2: Best practices. Postgrad Med. 2014; 126(7): 129-138.

Dowell D, Haegerich TM: Using the CDC Guideline and Tools for Opioid Prescribing in Patients with Chronic Pain. Am Fam Physician. 2016; 93(12): 970-972.

Iacobellis A, Seripa D, Palmieri O, et al.: Efficacy and Safety of Long-Term Administration of Tapentadol in Relieving Chronic Pancreatitis Pain. Pain Med. 2017; 18(4): 815-817.

Howard RF, Radic T, Sohns M, et al.: Tapentadol Prolonged Release for Long-Term Treatment of Pain in Children. J Pain Res. 2020; 13: 3157-3170.

Davis MP, Mehta Z: Opioids and Chronic Pain: Where Is the Balance? Curr Oncol Rep. 2016; 18(12): 71.

Bialas P, Maier C, Klose P, et al.: Efficacy and harms of long-term opioid therapy in chronic non-cancer pain: Systematic review and meta-analysis of open-label extension trials with a study duration >/=26 weeks. Eur J Pain. 2020; 24(2): 265-278.

Heit HA, Covington E, Good PM: Dear DEA. Pain Med. 2004; 5(3): 303-308.

Chang Y, Moody DE: Glucuronidation of buprenorphine and norbuprenorphine by human liver microsomes and UDP-glucuronosyltransferases. Drug Metab Lett. 2009; 3(2): 101-107.

Huang W, Moody DE, McCance-Katz EF: The in vivo glucuronidation of buprenorphine and norbuprenorphine determined by liquid chromatography-electrospray ionization-tandem mass spectrometry. Ther Drug Monit. 2006; 28(2): 245-251.

Picard N, Cresteil T, Djebli N, et al.: In vitro metabolism study of buprenorphine: evidence for new metabolic pathways. Drug Metab Dispos. 2005; 33(5): 689-695.

Ohtani M, Kotaki H, Sawada Y, et al.: Comparative analysis of buprenorphine- and norbuprenorphine-induced analgesic effects based on pharmacokinetic-pharmacodynamic modeling. J Pharmacol Exp Ther. 1995; 272(2): 505-510.

Tournier N, Chevillard L, Megarbane B, Pet al.: Interaction of drugs of abuse and maintenance treatments with human P-glycoprotein (ABCB1) and breast cancer resistance protein (ABCG2). Int J Neuropsychopharmacol. 2010; 13(7): 905-915.

Alhaddad H, Cisternino S, Decleves X, et al.: Respiratory toxicity of buprenorphine results from the blockage of P-glycoprotein-mediated efflux of norbuprenorphine at the bloodbrain barrier in mice. Crit Care Med. 2012; 40(12): 3215-3223.

Megarbane B, Hreiche R, Pirnay S, et al.: Does high-dose buprenorphine cause respiratory depression?: Possible mechanisms and therapeutic consequences. Toxicological Reviews. 2006; 25(2): 79-85.

Megarbane B, Marie N, Pirnay S, et al.: Buprenorphine is protective against the depressive effects of norbuprenorphine on ventilation. Toxicol Appl Pharmacol. 2006; 212(3): 256-267.

Middleton LS, Nuzzo PA, Lofwall MR, et al.: The pharmacodynamics and pharmacokinetic profile of intranasal crushed buprenorphine and buprenorphine/naloxone tablets in opioid abusers. Addiction. 2011; 106(8): 1460-1473.

Le Rouzic V, Narayan A, Hunkle A, et al.: Pharmacological Characterization of Levorphanol, a G-Protein Biased Opioid Analgesic. Anesth Analg. 2019; 128(2): 365-373.

Lu Z, Xu J, Xu M, et al.: Truncated mu-Opioid Receptors With 6 Transmembrane Domains Are Essential for Opioid Analgesia. Anesth Analg. 2018; 126(3): 1050-1057.

Grinnell SG, Ansonoff M, Marrone GF, et al.: Mediation of buprenorphine analgesia by a combination of traditional and truncated mu opioid receptor splice variants. Synapse. 2016; 70(10): 395-407.

Marrone GF, Majumdar S, Pasternak GW: Radioligand Binding Assay for an Exon 11-Associated Mu Opioid Receptor Target. Methods Mol Biol. 2015; 1335: 241-249.

Grinnell SG, Majumdar S, Narayan A, et al.: Pharmacologic characterization in the rat of a potent analgesic lacking respiratory depression, IBNtxA. J Pharmacol Exp Ther. 2014; 350(3): 710-718.

Majumdar S, Subrath J, Le Rouzic V, et al.: Synthesis and evaluation of aryl-naloxamide opiate analgesics targeting truncated exon 11-associated mu opioid receptor (MOR-1) splice variants. J Med Chem. 2012; 55(14): 6352-6362.

Abbadie C, Pan YX, Pasternak GW: Immunohistochemical study of the expression of exon11-containing mu opioid receptor variants in mouse brain. Neuroscience. 2004; 127(2): 419-430.

White LD, Hodge A, Vlok R, et al.: Efficacy and adverse effects of buprenorphine in acute pain management: Systematic review and meta-analysis of randomised controlled trials. Br J Anaesth. 2018; 120(4): 668-678.

Aiyer R, Gulati A, Gungor S, et al.: Treatment of Chronic Pain With Various Buprenorphine Formulations: A Systematic Review of Clinical Studies. Anesth Analg. 2018; 127(2): 529-538.

Wolff RF, Reid K, di Nisio M, et al.: Systematic review of adverse events of buprenorphine patch versus fentanyl patch in patients with chronic moderate-to-severe pain. Pain Manag. 2012; 2(4): 351-362.

Wolff RF, Aune D, Truyers C, et al.: Systematic review of efficacy and safety of buprenorphine versus fentanyl or morphine in patients with chronic moderate to severe pain. Curr Med Res Opin. 2012; 28(5): 833-845.

van Dam CJ, Algera MH, Olofsen E, et al.: Opioid utility function: Methods and implications. Ann Palliat Med. 2020; 9(2): 528-536.

Boom M, Niesters M, Sarton E, et al.: Non-analgesic effects of opioids: opioid-induced respiratory depression. Curr Pharm Des. 2012; 18(37): 5994-6004.

Yassen A, Olofsen E, van Dorp E, et al.: Mechanism-based pharmacokinetic-pharmacodynamic modelling of the reversal of buprenorphine-induced respiratory depression by naloxone: A study in healthy volunteers. Clin Pharmacokinet. 2007; 46(11): 965-980.

Yassen A, Olofsen E, Kan J, et al.: Pharmacokinetic-pharmacodynamic modeling of the effectiveness and safety of buprenorphine and fentanyl in rats. Pharm Res. 2008; 25(1): 183-193.

Yassen A, Olofsen E, Kan J, et al.: Animal-to-human extrapolation of the pharmacokinetic and pharmacodynamic properties of buprenorphine. Clin Pharmacokinet. 2007; 46(5): 433-447.

Yassen A, Olofsen E, Romberg R, et al.: Mechanism-based pharmacokinetic-pharmacodynamic modeling of the antinociceptive effect of buprenorphine in healthy volunteers. Anesthesiology. 2006; 104(6): 1232-1242.

Dahan A, Yassen A, Romberg R, et al.: Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth. 2006; 96(5): 627-632.

Dahan A, Yassen A, Bijl H, et al.: Comparison of the respiratory effects of intravenous buprenorphine and fentanyl in humans and rats. Br J Anaesth. 2005; 94(6): 825-834.

Yassen A, Olofsen E, Dahan A, et al.: Pharmacokinetic-pharmacodynamic modeling of the antinociceptive effect of buprenorphine and fentanyl in rats: Role of receptor equilibration kinetics. J Pharmacol Exp Ther. 2005; 313(3): 1136-1149.

Dinges HC, Otto S, Stay DK, et al.: Side Effect Rates of Opioids in Equianalgesic Doses via Intravenous Patient-Controlled Analgesia: A Systematic Review and Network Metaanalysis. Anesth Analg. 2019; 129(4): 1153-1162.

Lazaridou A, Paschali M, Edwards RR, et al.: Is Buprenorphine Effective for Chronic Pain? A Systematic Review and Meta-analysis. Pain Med. 2020; 21(12): 3691-3699.

Urits I, Pham C, Swanson D, et al.: The utilization of buprenorphine in chronic pain. Best Pract Res Clin Anaesthesiol. 2020; 34(3): 355-368.

Brown SM, Holtzman M, Kim T, et al.: Buprenorphine metabolites, buprenorphine-3-glucuronide and norbuprenorphine-3-glucuronide, are biologically active. Anesthesiology. 2011; 115(6): 1251-1260.

Downloads

Published

08/01/2021

How to Cite

Davis, MD, FCCP, FAAHPM, M. P., and J. Fudin, PharmD, FACCP, FASHP, FFSMB. “Buprenorphine Not a Silver Bullet But an Opioid of Choice for Chronic Pain”. Journal of Opioid Management, vol. 17, no. 7, Aug. 2021, pp. 11-14, doi:10.5055/jom.2021.0619.