Effects of buprenorphine buccal (chronic pain): A Synthesis of Findings from 9 Studies

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Original Abstract of the Article

Major Research Findings

Clinical studies demonstrate that buprenorphine is a pharmacological agent that can be used for the treatment of various types of painful conditions. 8 This study investigated the efficacy of 5 different types of buprenorphine formulations in the chronic pain population. 8 Of the 25 studies reviewed, a total of 14 studies demonstrated clinically significant benefit with buprenorphine in the management of chronic pain. 8 A transdermal buprenorphine formulation is an effective analgesic in patients with chronic pain. 8 Buccal buprenorphine is also a promising formulation based on the limited number of studies. 8

A case report demonstrated a successful transition from a full opioid agonist to buccal buprenorphine in a patient with chronic pain. 4 The patient was able to successfully taper off the full opioid agonist while gradually increasing buprenorphine, without experiencing withdrawal symptoms. 4 This approach resulted in improved quality of life and function for the patient. 4

Buprenorphine buccal film (BBF) is approved by the US Food and Drug Administration for use in patients with chronic pain severe enough to require daily, around-the-clock, long-term opioid treatment. 2 A Phase I placebo-controlled trial comparing BBF with oral oxycodone hydrochloride found that BBF had a ceiling effect on respiratory depression, unlike full μ-opioid receptor agonists. 2

A new BioErodible MucoAdhesive (BEMA®) delivery system for buprenorphine has been developed to treat chronic low back pain (cLBP). 5 The buccal buprenorphine (BBUP) film developed for this product (Belbuca™) allows for rapid delivery and titration over a greater range of doses than was previously available with transdermal buprenorphine systems. 5 In clinical studies, BBUP was shown to effectively reduce pain associated with cLBP at 12 weeks with good tolerability. 5 Chronic pain patients using other opioids can be successfully rotated to BBUP without risk of withdrawal symptoms or inadequate analgesia. 5

An animal study evaluated the analgesic effect and absorption of buprenorphine after buccal administration in cats with oral disease. 9 The results demonstrated that buccal administration of buprenorphine produced an analgesic effect in cats with gingivostomatitis. 9

Benefits and Risks

Benefit Summary

Buprenorphine may be a clinically significant benefit in the management of chronic pain. 8 Transdermal buprenorphine has been shown to be an effective analgesic in patients with chronic pain. 8 Buccal buprenorphine is also a promising formulation. 8 Buprenorphine may be a safe and effective alternative to traditional opioids for many patients with chronic pain. 3 Buprenorphine has been shown to have a ceiling effect on respiratory depression, unlike full μ-opioid receptor agonists. 2 Buprenorphine buccal film allows for rapid delivery and titration over a greater range of doses than was previously available with transdermal buprenorphine systems. 5 Buprenorphine may provide effective analgesia while producing less adverse effects. 6

Risk Summary

Buprenorphine can cause side effects such as nausea, constipation, and vomiting. 5 Buprenorphine is a Schedule III opioid, which means it has the potential for abuse and addiction. 1

Comparison Across Studies

Commonalities

Many studies suggest that buprenorphine may be effective in managing chronic pain. 8 Many studies reported good tolerability of buprenorphine, with no serious adverse effects. 8

Differences

Studies vary in their buprenorphine formulations, study designs, and types of chronic pain investigated. 8 Some studies specifically investigated the efficacy of buprenorphine for certain types of chronic pain, while others looked at a broader range of conditions. 8

Consistency and Contradictions in Results

The evidence suggests that buprenorphine may be an effective option for managing chronic pain. 8 However, there may be differences in effectiveness and safety depending on the buprenorphine formulation and administration method. 8 Further research is needed to determine the optimal formulation and administration method for using buprenorphine in chronic pain management. 8

Considerations for Real-World Application

Buprenorphine may be effective in managing chronic pain, but it is essential to use it as directed by a doctor. 8 Buprenorphine is a Schedule III opioid and has the potential for abuse and addiction. 1 Talk to your doctor before taking buprenorphine. 8

Limitations of Current Research

This review examined a limited number of studies to evaluate the efficacy and safety of buprenorphine. 8 Furthermore, many studies focused on patients with specific types of chronic pain. 8 Additional research is needed to investigate how buprenorphine affects other types of chronic pain. 8

Future Research Directions

Future studies should investigate the efficacy of buprenorphine for different types of chronic pain. 8 Further research is also needed to determine the optimal dosage and administration method for buprenorphine. 8

Conclusion

Buprenorphine may be a promising medication for managing chronic pain. 8 However, it is crucial to use it as directed by a doctor since buprenorphine is a Schedule III opioid with the potential for abuse and addiction. 1 Talk to your doctor before taking buprenorphine. 8

Literature analysis of 9 papers
Positive Content
9
Neutral Content
0
Negative Content
0
Article Type
1
1
3
2
8
1.

Buprenorphine buccal film for chronic pain management.

Author: HaleMartin, GimbelJoseph, RauckRichard

Opioid safety
Pain relief

This review article discusses the advantages of buprenorphine buccal film for the treatment of chronic pain compared to other buprenorphine formulations and other opioids. The review highlights the bioavailability, safety, and efficacy of buprenorphine buccal film.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

A Phase I Placebo-Controlled Trial Comparing the Effects of Buprenorphine Buccal Film and Oral Oxycodone Hydrochloride Administration on Respiratory Drive.

Author: WebsterLynn R, HansenErik, CaterJacqueline, SmithThomas

Pain management

This study compared the effects of buprenorphine buccal film (BBF) and immediate-release oral oxycodone hydrochloride administration on respiratory drive.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Successful buprenorphine transition while overlapping with a full opioid agonist to treat chronic pain: a case report.

Author: PatelKishan V, SahniSidharth, TaylorLanvin F

Opioid withdrawal
Pain relief

Buprenorphine is a medication used to treat both chronic pain and opioid use disorder. This case study details a successful transition of a patient from a full opioid agonist to buprenorphine, demonstrating a potentially safer and more effective approach for pain management.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

5.

Management of moderate to severe chronic low back pain with buprenorphine buccal film using novel bioerodible mucoadhesive technology.

Author: PergolizziJoseph V, RaffaRobert B, FleischerCharles, ZampognaGianpietro, TaylorRobert

cLBP treatment
Constipation
Nausea
Vomiting

This article discusses the use of buccal buprenorphine (BBUP) film in the treatment of chronic low back pain (cLBP). BBUP was shown to effectively reduce pain associated with cLBP at 12 weeks with good tolerability. The most frequently reported side effects were nausea, constipation, and vomiting.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Analgesic Effect of Buprenorphine for Chronic Noncancer Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Author: WongStanley Sau Ching, ChanTak Hon, WangFengfeng, ChanTimmy Chi Wing, HoHung Chak, CheungChi Wai

Analgesia
Fewer side effects
Euphoria
Respiratory depression

Buprenorphine is a partial opioid agonist that may provide effective analgesia with fewer adverse effects. This systematic review and meta-analysis investigated the analgesic efficacy of buprenorphine for chronic noncancer pain.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Evaluation of Buprenorphine Rotation in Patients Receiving Long-term Opioids for Chronic Pain: A Systematic Review.

Author: PowellVictoria D, RosenbergJack M, YagantiAvani, GarpestadClaire, LagisettyPooja, ShannonCarol, SilveiraMaria J

Improved tolerability
No withdrawal
Reduced pain
High risk of bias
Limited evidence

This systematic review synthesized the evidence on rotation to buprenorphine from long-term opioid therapy (LTOT) in individuals with chronic pain. The review found that buprenorphine was associated with reduced pain intensity without precipitating opioid withdrawal. Steady-dose buprenorphine was better tolerated than tapered-dose buprenorphine. Future research is needed to determine the optimal approach to buprenorphine rotation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

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

Author: AiyerRohit, GulatiAmitabh, GungorSemih, BhatiaAnuj, MehtaNeel

Chronic pain management
Pain reduction
No serious adverse effects reported

This review examined the effectiveness of different buprenorphine formulations for managing chronic pain. The review found that transdermal buprenorphine was the most effective formulation, with buccal buprenorphine also showing promise.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Evaluation of analgesic effect and absorption of buprenorphine after buccal administration in cats with oral disease.

Author: StathopoulouThaleia-Rengina, KoukiMaria, PypendopBruno H, JohnstonAtholl, PapadimitriouSerafeim, PelligandLudovic

Analgesic effect

Buprenorphine is a pain reliever that can be given to cats. This study looked at the effectiveness of giving buprenorphine to cats with mouth pain. The study found that buprenorphine was effective in reducing pain and that it was safe for cats to take.

Clinical Trial, VeterinaryClinical trials involving animals. They are conducted to evaluate the safety and efficacy of new drugs and treatments and contribute to the advancement of veterinary medicine.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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