Tapentadol for neuropathic pain: a review of clinical studies

Figures & data

Figure 1 Schematic drawing of the dual mode action of tapentadol. Reproduced with permission from Chang EJ, Choi EJ, Kim KH. Tapentadol: can it kill two birds with one stone without breaking windows? Korean J Pain. 2016 Jul;29(3):153–157.⁴¹

Table 1 Effects of tapentadol on neuropathic pain

Author	Condition	Study features				Tapentadol mean daily dose (mg)	Pain		Neuropathic pain
		Patient number	Duration (months)	Type	Comparator		NRS/VAS decrease	Responders (%)	DN4/NPSI/PDQ decrease	Responders (%)
Musculoskeletal pain conditions
Billeci^Citation88	CNP	44	3	PO		204.5±102.8	5.1	68^B	DN4, 2.2^B	47^dB
Baron^Citation85	LBP	130	3	RCT	Oxycodone	378.8±129.6	3.7		PDQ, 10.8
Baron^Citation83	LBP	59 154 159	3	PO DB DB	Pregabalin	300 500 300	5.2 4. 4.2		PDQ, 12.3^B PDQ, 10.3^B PDQ, 11.0^B
Passavanti^Citation84	LBP	55	6	R PO	Tapentadol-PEA	158.0±8.50 121.7±6.20	−1.8^A	68^cA	DN4, 1.8^A	28^cA
Tedeschi^Citation61	PAD	25	3	PO		186.4±56.0	5.1^B	80^a	DN4, 2.8^B	78^d
Ueberall^Citation86	LBP	133	3	R	Oxycodone	298.5±71.2	31.2^A −3.8^B	84^g −1.7	PDQ7, 5	42^a
Cancer pain conditions
Sugiyama^Citation103	SC	30	2,1	R		100	3
Brunetti^Citation94	HC	36	1	PO		243.5±105.6	7		DN4, 3.4	75^d
Coluzzi^Citation93	MM	25	3	PO		213.6±94.1	4,7		DN4, 4.3	100^d
Neurological pain conditions
Galiè^Citation65	CIPN	31	3	PO		200	3.4^B	86^a	DN4, 2.2^B	78^b
Vinik^Citation59	DPN	318	3	RCT	Placebo	100–250	0.95^A	40^A^a	NPSI, 8.84^A
Niesters^Citation43	DPN	25	1	RCT	Placebo	433±31	0.8^A
Schwartz^Citation60	DPN	196	3	RCT	Placebo	200–500	1.3^A	39^a
Freo^Citation102	PD	21	6	R		206.3±102.7	2.5^B	48^a	PDQ, 6.3^B	100^f

Notes: Responders: ^aVAS/NRS ≥50% reduction; ^bDN₄>30% reduction; ^cVAS and/or DN₄ 2 point reduction; ^dDN₄<4; ^ePDQ7 reduction to <18; ^fPD reduction to ≤18; ^glow back pain intensity index. Statistics: ^Aintergroup comparison, significantly different from placebo or oxycodone; ^Bintragroup comparison, significantly different from baseline.

Abbreviations: CIPN, chemotherapy induced peripheral neuropathy; DN₄, douleur neuropathique en 4 questions; DPN, diabetic peripheral neuropathy; HC, hematholocical cancer; LBP, low back pain; multiple myeloma; NPSI, Neuropathic Pain Symptom Inventory; NRS/VAS, 0–10 Numerical Rating Scale/0–10 Visual Analogue Scale; NP, neuropathic pain; PDQ, painDetect questionnaire; PDQ7, seven-item painDetect; PD, Parkinson’ disease; PEA, palmytoilethanoamine; PHN, postherpetic neuralgia; PO, prospective observational; R, retrospective; RCT, randomized-controlled trial; SC: solid cancers.

Figure 2 Means (± SD) of painDetect questionnaire score (PDQ) at pretreatment (solid columns) and after 3-month (densely hatched columns) and 6-month (lightly hatched columns) treatment with tapentadol for chronic musculoskeletal pain, across different age groups. **Different from baseline (P<0.01, 6-month PDQ vs pretreatment PDQ, for all age group; 1-way ANOVA and t-test).

Figure 3 Parkinson’s disease patients (percentage) who presented with nociceptive pain (open bars), mixed pain (hatched bars) and neuropathic pain (solid bars) at pretreatment baseline, and at follow-up assessment at month 3 and 6 of treatment with tapentadol.

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