Tapentadol prolonged release for patients with multiple myeloma suffering from moderate-to-severe cancer pain due to bone disease

Flaminia Coluzzi; Robert B Raffa; Joseph Pergolizzi; Alessandra Rocco; Pamela Locarini; Natalia Cenfra; Giuseppe Cimino; Consalvo Mattia

doi:10.2147/JPR.S83490

Tapentadol prolonged release for patients with multiple myeloma suffering from moderate-to-severe cancer pain due to bone disease

J Pain Res. 2015 May 8:8:229-38. doi: 10.2147/JPR.S83490. eCollection 2015.

Authors

Flaminia Coluzzi¹, Robert B Raffa², Joseph Pergolizzi³, Alessandra Rocco⁴, Pamela Locarini⁴, Natalia Cenfra⁵, Giuseppe Cimino⁵, Consalvo Mattia¹

Affiliations

¹ Department of Medical and Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Unit of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Polo Pontino, Sapienza University of Rome, Latina, Italy ; SIAARTI Study Group on Acute and Chronic Pain, Rome, Italy.
² Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA, USA.
³ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Department of Medical and Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Unit of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Polo Pontino, Sapienza University of Rome, Latina, Italy.
⁵ Department of Cellular Biotechnology and Hematology, Sapienza University of Rome, Rome, Italy.

Abstract

Context: Myeloma bone disease (MBD) is a devastating complication of multiple myeloma that leads to severe pain.

Objectives: The aim of this study was to evaluate the efficacy and tolerability of tapentadol prolonged release (PR) in the management of patients with MBD suffering from moderate-to-severe cancer pain.

Methods: A 12-week prospective study was carried out in 25 opioid-naïve MBD patients. Patients initially received twice-daily doses of tapentadol PR 50 mg. Doses were then managed to maintain adequate relief or dose-limiting toxicity. The following parameters were recorded at weekly intervals for 4 weeks, and then at weeks 8 and 12: pain, opioid-related adverse effects, use of other analgesics, DN4 (Douleur Neuropathique 4) score. Quality of life (SF-36 [36-item short-form health survey]) was measured at baseline and at final evaluation.

Results: Of 25 patients, 22 completed the study. Pain intensity significantly decreased from baseline to all the week intervals (P<0.01). Quality of life significantly improved with respect to all SF-36 subscale parameters (P<0.01), and so did both the physical and mental status (P<0.01). Tapentadol PR significantly reduced DN4 mean value (P<0.01) and the number of patients with neuropathic component (DN4 ≥4) (P<0.01). After 8 weeks of treatment, all patients were negative for the DN4 score. Tapentadol PR was well tolerated, and the use of other analgesics was reduced during the study period.

Conclusion: Tapentadol PR started in doses of 100 mg/day was effective and well tolerated in opioid-naïve MBD patients with moderate-to-severe pain. Tapentadol PR can be considered a first-choice opioid in cancer patients suffering from mixed pain with a neuropathic component.

Keywords: bone; multiple myeloma; neuropathic pain; opioids; tapentadol.