Transdermal fentanyl for chronic pain in AIDS: A pilot study

This prospective, open-label, before-after trial was designed to compare th e efficacy of oral opioids with that of transdermal fentanyl in severe AIDS -related chronic pain as well as assess barriers, patient satisfaction, and side effects. Thirty-five sequentially selected male and female outpatient s with AIDS who were at least 18 years old were enrolled. All had chronic p ain requiring continuous treatment with greater than or equal to 45 mg/day oral morphine or an equivalent. Eighteen of the patients had a history of c hemical dependency. Baseline data were collected while patients received th eir previously prescribed opioid; assessments were made again after a stabl e transdermal fentanyl dose (25-300 mug/h) had been maintained for 15 days. Patients completed the International Association for the Study of Pain Cla ssification of Chronic Pain Syndromes questionnaire, the Brief Pain Invento ry, and a Satisfaction with Pain medication questionnaire for assessing pai n intensity, relief, and interference with normal functioning. With transde rmal fentanyl, pain severity scores decreased significantly, mean, pain rel ief scores increased, and daily functioning measures improved significantly . Most adverse events were mild and unrelated to fentanyl use. Transdermal fentanyl was effective for chronic pain in both chemically dependent and no n-chemically dependent patients with AIDS. (C) U.S. Cancer Pain Relief Comm ittee, 2001.