Efficacy and tolerability of tapentadol prolonged release in the elderly and fragile patient: an observational study

摘要

OBJECTIVE: The incidence of chronic pain increases with age and comorbidities, a particularly relevant issue in the elderly over the age of 80 years. Thus, the choice of the best analgesic treatment is difficult to make. The therapeutic priority in elderly patients is to favor the least invasive route of administration, and the minimum effective dose, with a gradual and slow up-titration, if needed. Tapentadol with its dual mechanism of action, combining synergistically a reduced load (80 years) with chronic pain from different etiologies received tapentadol PR daily over 8 weeks. RESULTS: At the end of the study, responders to treatment were 43% (20/47 patients). Compared with baseline, pain intensity, both at rest and during loading, decreased by 60% and by 55%, respectively (p0.0001). Tolerability was high throughout the study period, with 92% of patients grading it either good or excellent during follow-up. In total, 16 episodes of side effects were reported, with five considered severe and leading to therapy discontinuation. Ten cases of therapy discontinuation occurred, most of them (five patients, 10%) due to the ineffectiveness of analgesic treatment. CONCLUSIONS: Tapentadol PR, adequately titrated according to patients’ need, are safe and effective to control pain in most elderly patients.