The following article is part of conference coverage from the IASP 2018 conference in Boston, Massachusetts. Clinical Pain Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from IASP 2018.

Fast-dissolving oral piroxicam may represent an effective alternative to sublingual fentanyl for treating incidental breakthrough pain attacks caused by bone metastasis, according to a study to be presented at the World Congress on Pain 2018, held September 12-16 in Boston, Massachusetts.

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Researchers conducted a double-blind randomized trial to determine the efficacy of oral piroxicam fast-dissolving tablets vs sublingual fentanyl in controlling incidental breakthrough pain attacks in 100 patients with bone metastasis. There were no significant differences between groups with regard to baseline characteristics.

The study’s primary outcomes were reduction in pain intensity (assessed using a visual analog scale), frequency of breakthrough pain attacks, and onset of pain relief. Patients receiving both treatment options had significant reductions in visual analog scale scores compared with pretreatment values (P =.001). 

These reductions in pain intensity as well as the duration of pain attacks and the number of rescue doses were not significantly different between the 2 groups. Study participants who received oral piroxicam had a significant reduction in multiple Brief Pain Inventory items (relation with others), sleep pattern, and enjoyment of life parameters at weeks 2 and 4.

Based on these findings, the researchers concluded that “oral piroxicam fast-dissolving tablet is an analgesic alternative to sublingual fentanyl in patients with bone metastasis to control incidental breakthrough pain attacks with more favorable cost benefit values.”

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Yousef A. The efficacy of oral piroxicam fast-dissolving tablets versus sublingual fentanyl in incidental breakthrough pain due to bone metastases. Double blinded randomized study. Presented at: World Congress on Pain 2018; September 12-16, 2018; Boston, MA. Poster 63530.

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