Long-Term Use of Actiq Safe and Effective for Breakthrough Pain

BALTIMORE—For cancer patients with breakthrough pain, oral transmucosal fentanyl (Actiq) continues to provide good relief with long-term use, Richard Payne, MD, said at the 21st Annual Scientific Meeting of the American Pain Society (abstract 770).

The study followed 156 outpatients who had completed double-blind, controlled trials of Actiq. The patients, from 32 centers, began Actiq at the same dose reached during successful titration and continued to use around-the-clock opioids for persistent pain, said Dr. Payne, of Memorial Sloan-Kettering Cancer Center.

Overall, the patients used more than 83,000 doses of Actiq to treat more than 77,000 episodes of breakthrough pain. During the first month of the study, patients reported a mean of 2.7 episodes per day, with 93% of episodes successfully treated with one Actiq dose. After 9 months, patients reported a mean of 3.8 daily episodes, and these were successfully relieved with a single Actiq dose 92% of the time. More than half of the patients (55%) required no dose escalation during the course of the study.

Using the 5-point Global Medication Performance scale, patients rated Actiq above "very good" throughout the study: 3.1 at 1 month to 3.2 at 9 months. The most common adverse events considered to be at least possibly related to Actiq use were nausea (10%), somnolence (9%), dizziness (8%), and vomiting (7%).

Dr. Payne and his colleagues concluded that "Actiq is an effective and well-tolerated treatment option for the long-term management of breakthrough pain. Patients rated Actiq’s performance at least very good regardless of its duration of use."