Tapentadol prolonged release for managing moderate to severe chronic neck pain with or without a neuropathic component

Abstract

Background

Despite the high prevalence of neck pain, few studies have addressed the pharmacological treatment of this condition.

Purpose

We evaluated the effectiveness of tapentadol prolonged-release (PR) in patients with or without a neuropathic pain component, with a focus on functional movements, disability and Quality of Life (QoL).

Study design/setting

Observational, retrospective study.

Patient sample

Ninety-four adult patients with severe neck pain not responsive to opioid step III treatment.

Outcome measures

The primary endpoint was a ≥ 30% improvement of pain intensity at 4 weeks (W4). Several secondary outcomes were evaluated, including neck disability index (NDI), range of motion (ROM), and QoL.

Methods

Patients received tapentadol PR at the starting dose of 100 mg/day. Dose titration was allowed in 50 mg increments, up to 500 mg daily.

Results

At W4, the primary endpoint of ≥30% improvement of pain was reported in 70% (n = 35; 95% confidence interval [CI]: 55–82%) of patients with a neuropathic pain component and in 69% (n = 20; 95% CI: 49–85%) of those without a neuropathic component. The percentage of patients reporting a neuropathic pain component significantly decreased from baseline (64.2%) to W4 (27.8%). NDI significantly improved in both groups at W12. ROM significantly improved in all three planes of motion (p < .01), with no difference between the two groups. Interference of pain with sleep and QoL also improved.

Conclusions

The reduction in pain provided by tapentadol is associated with functional recovery, which may in turn be linked to an improvement in QoL.

Keywords:

• Neck pain
• tapentadol
• pain
• neuropathic pain
• quality of life
• range of motion
• disability

Transparency

Declaration of funding

Grunenthal supported the medical writing assistance.

Declaration of financial/other relationships

FC and DB served as speakers and consultants for Grunenthal. The authors have no other competing interests to declare. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

Medical writing was performed by Luca Giacomelli, PhD and Ambra Corti; this assistance was supported by Grunenthal. Editorial assistance was provided by Aashni Shah (Polistudium srl); this assistance was supported by Grunenthal.

Author contributions

Study conception and design: FC, DB; data interpretation: All; data analysis: JP; manuscript writing: FC, DB; manuscript review and agree to submission: all.