Tapentadol immediate release effective against acute pain

The use of tapentadol immediate release (IR) for acute pain produces effects similar to other opioids at higher doses but is associated with fewer gastrointestinal adverse effects, according to the results of a meta-analysis.

Researchers searched multiple online databases for randomized controlled trials (RCTs) and observational studies evaluating the effect of tapentadol IR vs other orally administered IR opioids in acute pain.

The search yielded 13 studies and one abstract, involving a total of 12,814 patients, for inclusion in the systematic review. Of these, five studies and one abstract consisting of 9,108 patients were included in the qualitative review. Eight RCTs (n=3,706 patients) comparing 50–100 mg tapentadol IR versus 5–15 mg oxycodone IR were selected for the meta-analysis.

Pooled data showed that at the lowest dose (50 mg), tapentadol IR resulted in less pain control relative to oxycodone IR (standardized mean difference [SMD], 0.25, 95 percent confidence interval CI, 0.06–0.44; p<0.01). However, pain control did not significantly differ at higher doses of tapentadol (75 and 100 mg) or when a titration strategy was used.

In the qualitative analysis, tapentadol IR also had similar effects when compared with morphine IR and tramadol IR. Furthermore, the former was less likely to lead to gastrointestinal adverse effects, such as nausea and constipation.

The findings indicate that the newer opioid tapentadol IR may be considered as a first line option for acute pain, the researchers said.