Department of Anesthesiology

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Treatment of Chronic Pain With Various Buprenorphine Formulations: A Systematic Review of Clinical Studies.

TitleTreatment of Chronic Pain With Various Buprenorphine Formulations: A Systematic Review of Clinical Studies.
Publication TypeJournal Article
Year of Publication2017
AuthorsAiyer R, Gulati A, Gungor S, Bhatia A, Mehta N
JournalAnesth Analg
Date Published2017 Dec 11
ISSN1526-7598
Abstract

Clinical studies demonstrate that buprenorphine is a pharmacologic agent that can be used for the treatment of various types of painful conditions. This study investigated the efficacy of 5 different types of buprenorphine formulations in the chronic pain population. The literature was reviewed on PubMed/MEDLINE, EMBASE, Cochrane Database, clinicaltrials.gov, and PROSPERO that dated from inception until June 30, 2017. Using the population, intervention, comparator, and outcomes method, 25 randomized controlled trials were reviewed involving 5 buprenorphine formulations in patients with chronic pain: intravenous buprenorphine, sublingual buprenorphine, sublingual buprenorphine/naloxone, buccal buprenorphine, and transdermal buprenorphine, with comparators consisting of opioid analgesics or placebo. Of the 25 studies reviewed, a total of 14 studies demonstrated clinically significant benefit with buprenorphine in the management of chronic pain: 1 study out of 6 sublingual and intravenous buprenorphine, the only sublingual buprenorphine/naloxone study, 2 out of 3 studies of buccal buprenorphine, and 10 out of 15 studies for transdermal buprenorphine showed significant reduction in pain against a comparator. No serious adverse effects were reported in any of the studies. We conclude that a transdermal buprenorphine formulation is an effective analgesic in patients with chronic pain, while buccal buprenorphine is also a promising formulation based on the limited number of studies.

DOI10.1213/ANE.0000000000002718
Alternate JournalAnesth. Analg.
PubMed ID29239947

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