Comment on “Pain in the Frail or Elderly Patient: Does Tapentadol Have a Role?”

Excerpt

We wish to provide our comments and response to the current opinion article by Veal and Peterson entitled “Pain in the frail or elderly patient: does tapentadol have a role?” [1]. Whilst the paper appears to provide a sound background on the pathophysiology, pharmacological management and challenges associated with treating frail and elderly patients, its conclusions and recommendations should be questioned. It provides an excellent review of the background and management options available in this challenging population with a high prevalence of pain symptoms and the authors correctly point out that most previous studies, including the current studies on tapentadol, have largely been pharmaceutical industry sponsored, the numbers have been small, dropout rates have been universally quite high, intolerance substantial and benefits moderate. However, their final conclusions and key points regarding the potential role of tapentadol are significantly flawed and potentially discard the utility of a newer agent that may have value, especially in the older, frailer population at high risk of intolerance, adverse effects and drug interactions. …