Effective Management of Breakthrough Pain in Cancer Patients Using Intranasal Fentanyl

Meaningful pain relief at 10 minutes following dosing with intranasal fentanyl spray among patients with cancer who experience breakthrough pain was reported at the Fifth Research Forum of the European Association for Palliative Care, in Trondheim, Norway. All patients involved in the trial were already receiving effective treatment to control background pain, but still experienced episodes of breakthrough pain everyday. Intranasal fentanyl spray is aimed at managing breakthrough pain in adult patients with cancer who are already receiving maintenance opioid therapy for their background pain.

In all, 159 patients were included in the trial, who were given unmarked sprays delivering placebo or three different dose strengths of intranasal fentanyl which they were to use immediately when they experienced the onset of breakthrough pain. Meaningful pain relief was reported at 10 minutes after dosing in 29%, 42%, and 50% of patients taking doses of 50, 100, or 200 µg of intranasal fentanyl, compared with 22% for placebo.

Dr. Thomas Nolte, of the Pain and Palliative Care Centre, Wiesbaden, Germany, who led the team of investigators conducting the trial which involved patients from a number of countries in Europe, commented on the study, stating, "These results suggest that the intranasal fentanyl spray is a very promising treatment for breakthrough pain in patients with cancer. It is also easy to use, which means patients can be more independent, knowing they can simply administer their own analgesia and gain fast relief from their pain."