Clinical role and safety of tapentadol in patients with cancer: A single-center experience
DOI:
https://doi.org/10.5055/jom.2022.0719Keywords:
tapentadol, opioids, cancer pain, palliative care, neuropathic pain, opioid switch, adverse eventsAbstract
Objective: To evaluate real-world data on the use of tapentadol (TAP) in cancer patients.
Design: Single-center retrospective study.
Setting: Curative/palliative.
Patients, participants: Patients who started TAP between October 2014 and December 2018 at our institution.
Main outcome measure(s): The primary outcome was the reason for TAP initiation. Secondary outcomes included prescription duration, TAP cessation rate, reason for cessation, and adverse events (AEs). Since the palliative care team (PCT) tended to prescribe to cancer patients with intractable pain more often than patients in usual care, and also tended to prescribe opioids based on their characteristics, we decided to compare patients with and without PCT intervention.
Results: There were 175 patients who first received TAP during the study period, of whom 81 patients (46.3 percent) were male. The median age was 60 years. TAP was prescribed for opioid-naive patients in 45 (26 percent) cases and opioid switch in 130 (74 percent) cases. When comparing the PCT group (n = 121) and the non-PCT group (n = 54) using univariate analysis, the PCT group had a higher opioid switch rate (81.8 percent vs 57.4 percent, p < .001), higher proportion of patients with neuropathic pain (NP) (65.3 percent vs 16.7 percent, p < .001), and a higher proportion of patients with a history of nausea (41.3 percent vs 18.5 percent, p < .01). The cessation rate due to AEs was 8 percent overall.
Conclusions: Palliative care physicians prescribed TAP for patients with NP or a history of nausea. Opioid-naive patients were preferred by oncologists. TAP has good tolerability in both groups, with a low dropout rate due to AEs.
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