Efficacy and Safety of Buprenorphine Transdermal Patch in Non-cancer Pain of Moderate Intensity
Condition: Osteoarthritis; Rheumatoid Arthritis; Lower Back Pain; Joint Pain; Muscle Pain
MeSH terms: Arthritis; Osteoarthritis; Arthritis, Rheumatoid; Arthralgia; Myalgia; Back Pain; Low Back Pain
Intervention: Buprenorphine Transdermal Patch
Intervention MeSH terms: Buprenorphine
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 78.0
Sex: All
Minimum age: 40 Years
Healthy volunteers: No

Summary:

      This is a phase IV, open-label and single-arm study of patients with non-malignant pain due
      to osteoarthritis, rheumatoid arthritis, low back pain and joint/muscle pain, who were not
      responding to non-opioid analgesics. The primary objective was to assess the efficacy of
      buprenorphine transdermal patch for pain control among these patients.
    

Eligibility criteria:

        Inclusion Criteria:

          1. Males and females aged 40 years and above at the time of recruitment.

          2. Clinical diagnosis of osteoarthritis, rheumatoid arthritis, lower back pain or
             joint/muscle pain.

          3. Having non-malignant pain of moderate intensity requiring an opioid for adequate
             analgesia. This was determined using BS-11 scores, where the cut-off point is ≥4.

          4. Patients had to be opioid treatment naïve as defined by no opioid treatment (including
             tramadol, morphine etc.) in the preceding 1 month.

          5. Patients who have uncontrolled pain and had not responded to non-opioid analgesics for
             1 month or more.

          6. Patients who provided informed consent.

        Exclusion Criteria:

          1. Pregnant and lactating females.

          2. Patients with chronic condition(s), in addition to (osteoarthritis) OA, that required
             frequent analgesic treatment (e.g. frequent headaches, frequent migraine, and gout).

          3. Patients who were awaiting a scheduled operation or other surgical procedure during
             study period.

          4. Prior history of being on opioids in the preceding one month prior to the study for
             the management of chronic non-malignant pain.

          5. Patients with history of allergic reactions against paracetamol/acetaminophen, Non
             Steroidal Anti-Inflammatory drugs (NSAIDs) and/or opioids.

          6. Patients with allergies or other contraindications to transdermal systems or patch
             adhesives.

          7. Patients with dermatological disorders who may have problems applying patch or
             rotating patch placement area.

          8. Patients with cancer (except for basal cell carcinoma) or history of cancer who have
             been diagnosed within five years prior to the visit (except for treated basal cell
             carcinoma).

          9. Patients with conditions such as brain tumour, brain injury or raised intracranial
             pressure.

         10. Patients with history of psychiatric disorder, uncontrollable epilepsy, untreated
             depression or other psychiatric disorders of a type that would make participation in
             the study an unacceptable risk to the patient.

         11. Patients with any conditions causing poor cognitive function as assessed by the
             participating physician.

         12. Patients with history of alcohol and drug abuse or patients who had demonstrated
             behaviour that suggests a dependency or drug abuse.

         13. Patients who were at the time taking hypnotics or other central nervous system
             depressants that may pose a risk of additional central nervous system (CNS) depression
             with study medication.

         14. Patients who were at the time being administered monoamine oxidase inhibitors (MAOIs)
             or have taken MAOIs within 2 weeks before screening.

         15. Patients who were at the time taking adjuvant analgesics such as anti-depressants
             (e.g. amitriptyline, amoxapine, clomipramine, selective serotonin re-uptake inhibitors
             (SSRIs)) and anticonvulsants (e.g. gabapentin, pregabalin).

         16. Patients who had received steroid treatment (intra-articular, intramuscular, oral,
             intravenous, epidural or other corticosteroid injections) within 6 weeks prior to
             clinical study or planned steroid treatment during the clinical study period.

         17. Patients who had to use heating facility over area of patch (examples: heating lamp,
             electric blanket, sauna, warm compresses, heated saline baths, etc.).

         18. Patients who could not or did not wish to remove hair growing at body surface where
             the patch can be placed.

         19. Any other contraindication mentioned in the Summary of Product Characteristics for
             Sovenor® transdermal patch.

         20. Patients who were at the time on disability claims or in the process of applying for
             disability claims.

         21. Patients at child-bearing age who were planning to conceive a child during the study
             period and were not practicing adequate contraception.

         22. Patients with known severe hepatic impairment as determined by liver function test
             within the past one year. If liver function testing was not performed within 1 year
             prior to study initiation, patient had to undergo liver function testing prior to
             recruitment.

         23. Patients who were at the time in or had participated in other clinical trials within
             the last 30 days prior to study recruitment.

         24. Patients who were unable to comply to study visits.

         25. Patients who, in the investigator's opinion, were not suited to participate in the
             study involving the study medicine for any other reason not stated in the
             inclusion/exclusion criteria.