Transdermal patches effective for treatment of osteoarthritis pain

Key Points

Seven-day, transdermal buprenorphine patches are as effective as sublingual buprenorphine in the treatment of patients with osteoarthritis pain, according to a randomized, double-blind clinical trial recently published on-line ahead of print in the Journal of Pain and Symptom Management.

In this clinical trial, researchers randomized 246 patients (110 completed the study) between the ages of 18 and 80 with osteoarthritis pain in either the hip(s) and/or knee(s) to receive 7-day transdermal buprenorphine patches (5, 10, and 20 µg/hour) or sublingual buprenorphine (200-mg and 400-mg tablets). Both medications were titrated to pain control (over a 21-day period) and patients were treated for up to 7 weeks. The primary outcome measure of this study was pain intensity (as measured by Box Scale-11 [BS-11], where 0=no pain; 10=pain as bad as you can imagine) at day 28.

During the 28-day assessment period, the mean treatment differences in BS-11 scores were 0.00 (95% CI, –0.68 to 0.69), –0.11 (95% CI, –0.85 to 0.63), and –0.13 (95% CI, –0.95 to 0.68), for the morning, midday, and evening scores. All the confidence intervals were within the pre-specified limits (–1.5 to 1.5) suggesting equivalent pain control with buprenorphine patches and sublingual tablets. The use of escape medication was low.

In addition to equivalent efficacy, transdermal buprenorphine was found to have superior tolerability in this randomized trial. Significantly fewer patients receiving the transdermal buprenorphine patches reported nausea, dizziness and vomiting compared with the sublingual formulation (P<.039 for all).