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Conversion From Fast Acting Oral Opioids to Abstral®

Phase 4
Terminated
Conditions
Pain
Interventions
Registration Number
NCT01315886
Lead Sponsor
Orexo AB
Brief Summary

The purpose of this study is to evaluate safety and efficacy when using a novel dose conversion strategy to switch from immediate release oral opioids to sublingual (SL) fentanyl (Abstral) for treatment of breakthrough cancer pain (BTcP).

Detailed Description

The study aims to show that in the advanced stage of cancer the individual patient already on high doses of BTcP medication will benefit from starting treatment on a higher first dose of SL fentanyl thus reducing the number of dosing steps with insufficient pain relief.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
8
Inclusion Criteria
  • Signed informed consent obtained.
  • 18 years or older, of both genders.
  • Opioid tolerant patients
  • Estimated frequency of BTcP 0.5-4 times a day.
Exclusion Criteria
  • Treatment with SL fentanyl within two weeks prior to screening.
  • Recent or planned therapy that would alter pain or responses to analgesics.
  • Treatment with monoamine oxidase inhibitor < 14 days before or concurrent with SL fentanyl treatment.
  • Significantly reduced liver and/or kidney function.
  • Significant prior history of substance abuse.
  • Pregnancy, breast feeding or woman of childbearing potential not using adequate birth control.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
SL Fentanyl conversionSL fentanyl* Baseline period: 7-15 episodes of breakthrough cancer pain treated with prior IR opioid medication * Treatment period: Conversion to SL Fentanyl at a Fentanyl:Prior opioid conversion factor of 1:50 (using the estimated Morphine Sulphate Equivalent dose for the prior opioid). SL Fentanyl use was followed for 8-15 episodes of breakthrough cancer pain. SL Fentanyl dose could be titrated between episodes.
Primary Outcome Measures
NameTimeMethod
Response rate in patients converted to SL fentanyl.30 minutes post dose

A subject is defined as responder if the change of Pain Intensity (PI) on the Numerical Rating Scale (NRS) rated from 0 to 10, at 30 minutes (PID30) is similar or higher after the conversion to SL fentanyl compared to baseline PID30 as assessed by standard care rescue treatment of BTcP episodes.

Secondary Outcome Measures
NameTimeMethod
Occurrence of AEs, withdrawalsduring a maximum treatment period of 21 days.
Responder rate in patients converted to SL fentanyl as assessed by the PID15.15 minutes post dose
Patients preference of treatment (baseline treatment/SL fentanyl).end of study
Edmonton Symptom Assessment System (ESAS) Symptom Distress Score (SDS)24 hour assessment on days with pain episodes
Patient's global assessment of treatment (patient satisfaction).2 occasions

Trial Locations

Locations (1)

Smärtavdelning B42, Anestesikliniken Karolinska University Hospital, Huddinge

🇸🇪

Stockholm, Sweden

Smärtavdelning B42, Anestesikliniken Karolinska University Hospital, Huddinge
🇸🇪Stockholm, Sweden

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