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This study compared adverse outcomes and resource use for patients with a diagnosis of pain treated with tapentadol prolonged-release (PR) versus those treated with morphine controlled-release (CR) and oxycodone CR.
Data were sourced from the Clinical Practice Research Datalink (CPRD), a database derived from UK primary care. Patients prescribed tapentadol PR between May 2011 and December 2016 were selected and matched to two groups of controls treated with either morphine CR or oxycodone CR on gender, age, pain duration, pain site, pain aetiology, Charlson index and prior analgesia. Times to first adverse event (constipation or nausea/vomiting) were compared within a Cox proportional hazards model. Rates of primary care contacts, accident and emergency contacts and, for a subset of patients linked to Hospital Episode Statistics (HES), inpatient admissions and outpatient contacts were compared using incidence rate ratios (IRRs) derived from Poisson regression.
A total of 1907 patients prescribed tapentadol PR were identified and 1791 (93.9%) had a pain diagnosis. Of these 1246 (65.3%) were matched to morphine controls and 829 (43.4%) to oxycodone controls. Compared to controls, gastrointestinal adverse events with tapentadol PR treatment were reduced; aHR = 0.532 (0.402–0.703; p < 0.001) versus morphine CR and 0.517 (0.363–0.735; p < 0.001) versus oxycodone CR. Compared with morphine CR, primary care contacts [IRR = 0.831 (0.802–0.861)], accident and emergency attendance [0.739 (0.572–0.951)], outpatient contacts [0.917 (0.851–0.989)] and inpatients contacts [0.789 (0.664–0.938)] were reduced. For oxycodone, the respective figures were 0.735 (0.703–0.768), 0.971 (0.699–1.352), 0.877 (0.799–0.962) and 0.748 (0.601–0.932).
Tapentadol PR was associated with significantly fewer adverse gastrointestinal events than morphine CR and oxycodone CR in patients with a diagnosis of pain. There was also significantly reduced primary and secondary care resource use. As with all observational studies, potential bias due to residual confounding and confounding by indication should be considered.
Supplementary material 1 (DOCX 253 kb)12325_2019_932_MOESM1_ESM.docx
Merskey H. Pain terms: a list with definitions and notes on usage recommended by the IASP subcommittee on taxonomy. Pain. 1979;6:249–52. CrossRef
Breivik H, Collett B, Ventafridda V. Survey of chronic pain in Europe: prevalence, impact on daily life and treatment. Eur J Pain. 2006;10:287–333. CrossRef
Donaldson L. 150 years of the Annual Report of the Chief Medical Officer: on the state of public health 2008. London: Department of Health.
Tzschentke TM, Christoph T, Kögel B, et al. (−)-(1 R,2 R)-3-(3-Dimethylamino-1-ethyl-2-methyl-propyl)-phenol hydrochloride (tapentadol HCl): a novel μ-opioid receptor agonist/norepinephrine reuptake inhibitor with broad-spectrum analgesic properties. J Pharmacol Exp Ther. 2007;323:265–76. CrossRef
Mandala M, Moro C, Labianca R, et al. Optimizing use of opiates in the management of cancer pain. Ther Clin Risk Manag. 2006;2:447–53. CrossRef
Cherny N, Ripamonti C, Pereira J, et al. Strategies to manage the adverse effects of oral morphine: an evidence-based report. J Clin Oncol. 2001;19:2542–54. CrossRef
Lange B, Kuperwasser B, Okamoto A, et al. Efficacy and safety of tapentadol prolonged release for chronic osteoarthritis pain and low back pain. Adv Ther. 2010;27:381–99. CrossRef
Wild J, Grond S, Kuperwasser B, McCann B, Steup A, Rauschkol C. Long-term safety and tolerability of tapentadol extended release for the management of chronic low back pain or osteoarthritis pain. Pain Pract. 2010;10:416–27. CrossRef
Imanaka K, Tominaga Y, Etropolski M, Ohashi H, Hirose K, Matsumura T. Ready conversion of patients with well-controlled, moderate to severe, chronic malignant tumor-related pain on other opioids to tapentadol extended release. Clin Drug Investig. 2014;34:501–11. CrossRef
Kress HG, Koch ED, Kosturski H, et al. Tapentadol prolonged release for managing moderate to severe, chronic malignant tumor-related pain. Pain Phys. 2014;17:329–43.
Curtis L, Burns A (2016) Unit costs of health and social care 2016. Canterbury: Personal Social Services Research Unit, University of Kent.
Health & Social Care Information Centre. HRG4 2016/17 Local Payment Grouper. National Casemix Office, Winchester, UK. https://digital.nhs.uk/National-casemix-office/downloads-groupers-and-tools. Accessed 20 Oct 2018.
NHS National Tariff Payment System 2016/17. https://www.gov.uk/government/publications/nhs-national-tariff-payment-system-201617. Accessed 20 Oct 2018.
Buynak R, Shapiro DY, Okamoto A, et al. Efficacy and safety of tapentadol extended release for the management of chronic low back pain: results of a prospective, randomized, double-blind, placebo- and active-controlled phase III study. Expert Opin Pharmacother. 2010;11:1787–804. CrossRef
Afilalo M, Kuperwasser B, Kelly K, et al. Efficacy and safety of tapentadol extended release (ER) for chronic pain due to osteoarthritis of the knee: results of a phase 3 study. Pain Pract. 2009;9:159.
Hartrick C, Van Hove I, Stegmann JU, Oh C, Upmalis D. Efficacy and tolerability of tapentadol immediate release and oxycodone HCl immediate release in patients awaiting primary joint replacement surgery for end-stage joint disease: a 10-day, phase III, randomized, double-blind, active- and placebo-controlled study. Clin Ther. 2009;31:260–71. CrossRef
Stegmann JU, Weber H, Steup A, Okamoto A, Upmalis D, Daniels S. The efficacy and tolerability of multiple-dose tapentadol immediate release for the relief of acute pain following orthopedic (bunionectomy) surgery. Curr Med Res Opin. 2008;24:3185–96. CrossRef
Lin J, Chow W, Kim MS, Rupnow MF. Real-world treatment pattern and outcomes among patients who took tapentadol IR or oxycodone IR. J Med Econ. 2013;16:685–90. CrossRef
Ikenberg R, Hertel N, Moore RA, et al. Cost-effectiveness of tapentadol prolonged release compared with oxycodone controlled release in the UK in patients with severe non-malignant chronic pain who failed 1st line treatment with morphine. J Med Econ. 2012;15:724–36. CrossRef
Obradovic M, Ikenberg R, Hertel N, Antoñanzas F, Gálvez R, Liedgens H. Cost-effectiveness of tapentadol in severe chronic pain in Spain: a cost analysis of data from RCTs. Clin Ther. 2012;34:926–43. CrossRef
Merchant S, Noe LL, Howe A, et al. Budget impact analysis of tapentadol extended release for the treatment of moderate to severe chronic noncancer pain. Clin Ther. 2013;35:659–72. CrossRef
Bell T, Panchal S, Miaskowski C, Bolge S, Milanova T, Williamson R. The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European patient survey (probe 1). Pain Med. 2009;10:35–42. CrossRef
- Outcomes Associated with Treatment of Chronic Pain with Tapentadol Compared with Morphine and Oxycodone: A UK Primary Care Observational Study
Christopher Ll. Morgan
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