Trial Results with Intranasal Fentanyl Hold Promise for Treatment of Breakthrough Pain in Cancer
BUDAPEST, Hungary, June, 7, 2007--A pioneering nasal spray
could stop thousands of patients with cancer from suffering
unnecessary pain; it was reported today1 at the 10th Congress of
the European Association for Palliative Care, Budapest, 7–9
June. The study investigated whether this first in class novel
formulation could provide fast onset of pain relief and short
duration of effect, mirroring the breakthrough pain often
experienced by patients with cancer.
The majority of patients with cancer experience chronic pain during
the course of their illness.2 However, patients with cancer can
experience breakthrough pain despite adequate chronic background
pain treatment.3 Breakthrough pain comes on very quickly, lasts for
about 30 minutes on average, and can be very intense.2–4 The
ideal treatment should mimic the typical breakthrough pain episode
and provide tight control of the pain, i.e. fast but short-acting
pain relief.
The trial comparing intranasally with intravenously administered
fentanyl showed that pain relief in all patients was 6–8
minutes after intranasal administration.1 The duration of pain
relief provided by both routes was essentially the same.1 The
bioavailability of the intranasal administered fentanyl was
89%.1
Dr Lona Christrup of the University of Copenhagen, Denmark,
explained ‘As a model for patients with cancer, we tested
intranasal fentanyl to treat patients suffering pain after dental
surgery.’ Dr Christrup also stated that ‘The intranasal
fentanyl spray used in our study provided tight control of the pain
meaning fast onset of action and relatively short duration of
effect, making it a promising method for treating breakthrough
cancer pain. This method of administration has the added advantage
of being very easy to use, which is especially important for
patients with cancer.’
These findings were discussed in the ‘Challenges in treating
breakthrough pain’ satellite symposium, which examined the
problems in treating and managing this debilitating condition.
Breakthrough pain is a complex condition needing individualised
patient management,5 and is a very widespread problem among
patients with cancer.6 A drug with fast onset, short duration of
action and ease of use was deemed to be the ideal treatment.
Currently, oral morphine is the most frequently used treatment for
breakthrough pain. However, oral morphine is far from ideal for
patients with breakthrough cancer pain for two reasons. It takes
about 30 minutes to have an effect, missing the majority of the
breakthrough pain episode, and lasts for 4–6 hours, far
longer than the breakthrough pain episode.
Commenting on the trial findings, Dr Andrew Davies, Consultant in
Palliative Care, Royal Marsden Hospital said: ‘The results of
this trial are particularly interesting in terms of the potential
use of intranasal fentanyl to relieve breakthrough pain in patients
with cancer. This is a unique type of pain, and so needs a unique
form of treatment. Our research has shown that most patients are
prescribed strong oral opioid analgesics, despite the fact that
these are not the best choice of treatment. Greater attention needs
to be given to the problem of breakthrough pain, and healthcare
professionals need to be made aware of the general principles of
management, and particularly the pros and cons of different forms
of strong opioid analgesics.’
NOTES FOR EDITORS
A background document focusing on breakthrough cancer pain is
available on request.
For more information about breakthrough pain please visit the
breakthrough pain resource www.breakthroughpain.eu where
also full details of all presentations from the ‘Challenges
in treating breakthrough pain’ satellite symposium can be
found.
About Nycomed
Nycomed is an international pharmaceutical group that provides products for hospitals, specialists and general practitioners, as well as over-the-counter medicines in selected markets.
The company is active within a range of therapeutic areas, including cardiology, gastroenterology, osteoporosis, respiratory, pain and tissue management. New products are sourced both from own research and from external partners. Operating throughout Europe and in fast-growing markets such as Latin America, Russia/CIS and the Asia-Pacific region Nycomed has a presence in about 50 markets worldwide.
Privately owned, the combined group had non-audited estimated annual sales of approximately €3.4 billion and an EBITDA of €933.4 million (2006 results). In connection with the acquisition of the ALTANA Pharma AG, effective 1 January 2007, Nycomed is relocating its group headquarters from Roskilde (Denmark) to Zurich (Switzerland) in June 2007.
For more information visit www.nycomed.com
For further information
Dr Susan Craib, Wells Healthcare
Phone: +44 [0]1892 511600
Mobile: +44 [0]7703 544 957
Germany:
Susanne Hof, Nycomed, Head of External Communications
Phone: +49 7531 84 30 59
Mobile: +49 151 55 00 26 65
References
1. Popper L, Christrup L. Breakthrough pain: a randomised trial comparing nasal and intravenous fentanyl in patients with post-operative pain. Presented at the 10th Congress of the European Association for Palliative Care, Budapest, Hungary, 7–9 June 2007
2. Gomez-Batiste X, Madrid F, Moreno F, Gracia A, Trelis J, Nabal M, Alcalde R, Planas J, Camell H. Breakthrough cancer pain: prevalence and characteristics in patients in Catalonia, Spain. Journal of Pain and Symptom Management 2002;24:45–52
3. Zeppetella G O’Doherty CA, Collins S. Prevalence and characteristics of breakthrough pain in cancer patients admitted to a hospice. Journal of Pain and Symptom Management 2000;20:87–92
4. Portenoy R and Hagen NA. Breakthrough pain; definition, prevalence, and characteristics. Pain 1990;41:273–281
5. Davies A. The art of breakthrough pain treatment. Presented in Challenges in treating breakthrough pain satellite symposium at the 10th Congress of the European Association for Palliative Care, Budapest, Hungary, 7 June 2007
6. Kaasa S. Challenges in breakthrough pain treatment. Presented in Challenges in treating breakthrough pain satellite symposium at the 10th Congress of the European Association for Palliative Care, Budapest, Hungary, 7 June 2007
Posted: June 2007
