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INDIRECT TREATMENT COMPARISON OF THE TOLERABILITY OF TWO NON-INVASIVE PATIENT CONTROLLED ANALGESIA TREATMENTS FOR ACUTE POST-OPERATIVE PAIN MANAGEMENT
ESRA Academy. Katz P. Sep 8, 2016; 138249
Topic: Patient Controlled Analgesia
Pablo Katz
Pablo Katz

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Abstract
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Background and Aims:

Tolerability of a sufentanil sublingual delivery system (Zalviso®) versus a fentanyl iontophoretic transdermal system (Ionsys®), both indicated for acute moderate to severe post-operative pain, was compared in an exploratory analysis.

Methods:

Indirect treatment comparison (ITC) was performed based on studies collected by a systematic literature review conducted in the main databases (Embase, Medline, Cochrane) during a timeframe of around 10 years (2004-2015). Only active comparator studies were used in this analysis. Tolerability outcomes are presented as treatment withdrawals due to any cause, withdrawals due to AEs, and withdrawals due to lack of efficacy (i.e. inadequate analgesia).

Results:

Four studies were identified for Ionsys® while one study was identified for Zalviso® that could be used for the analysis. In all studies the active comparator was intra-venous patient controlled analgesia (i.v. PCA) with morphine. “Withdrawal due to any cause”-results indicated a numerically lower risk for Zalviso® (RR: 0.65; 95% CI: 0.42 to 1.02). While the risk of withdrawal due to adverse events (AEs) was equal for both treatments (RR: 1.02; 95% CI: 0.47 to 2.22) the risk of withdrawal due to lack of efficacy was significantly lower with Zalviso® (RR: 0.45; 95% CI: 0.21 to 0.98). (Figure 1)

Conclusions:

The risk of withdrawal due to AEs are equal between treatments what can be expected as both drugs are opioids. However the risk of withdrawals due to all causes and due to lack of efficacy are numerically or statistically in favour of Zalviso®.

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