Effects of Low-Dose Transdermal Buprenorphine on Chronic Non-Cancer Pain, Functional Capacities, Behavioural and Cognitive Levels in Elderly Patients: A Pilot, Retrospective, Real-World Study

Abstract

Introduction: Chronic pain affects up to 70% of the elderly general population. The use of transdermal buprenorphine may help relieve pain, but its use in elderly patients is hindered by concerns of adverse effects. In particular, its possible detrimental effect on the cognitive level throughout mechanisms involving the CNS is unclear. Also, the efficacy of buprenorphine patch on behavioural profile as well as on the functional level has yet to be clarified.

Methods: A 2-month, retrospective, pilot and real-world study was designed to explore the effects of transdermal buprenorphine on chronic pain, cognitive level, behavioural profile and functional abilities in elderly patients with persistent (≥3 months) moderate-severe chronic non-cancer pain (NRS >4). Buprenorphine patch was administered in the new-developed weekly formulation, with 5μg / h release. Cognitive level, behavioural symptoms and functional abilities were assessed at baseline and at the end of the study. Adverse events were recorded. ANOVA within group comparisons were performed.

Results: A total number of 97 patients were enrolled (baseline NRS 6.8±1.8, mean age 81±7) and n=90 patients completed the study. A statistically significant improvement was observed in NRS score and NPI score. No statistically significant changes in MMSE score, ADL/IADL scores were observed. Reported adverse events were all of mild intensity, with a decreasing trend over time.

Conclusion: Despite the short study duration, this pilot study suggests the short-term efficacy of buprenorphine patch in reducing moderate-severe chronic pain and in improving the neuropsychiatric/behavioural profile, with a good safety profile. Patients’ cognitive status was unaffected by the treatment.

 

Walter Gianni, Ilaria Spoletini, Colangelo Luciano, Riccardo Nicolucci, Cristiana Vitale, Giuseppe MC Rosano, Gianluca Mairone and Giustino Varrassi. Effects of Low-Dose Transdermal Buprenorphine on Chronic Non-Cancer Pain, Functional Capacities, Behavioural and Cognitive Levels in Elderly Patients: A Pilot, Retrospective, Real-World Study. Glob J Anes & Pain Med 5(2)-2023. GJAPM.MS.ID.000207.