Study data published in the Journal of Postgraduate Medicine showed that about half of study patients taking opioids and were prescribed topical analgesics for pain management discontinued their opioids after 3 or 6 months of treatment.
Opioid-experienced patients with chronic pain are at risk for misuse and abuse of, and addiction to opioids. Study authors described the lack of safe and effective “opioid-sparing multimodal alternative treatment strategies and approaches” for these patients. To better understand the role of topical analgesics, they reported on a subset analysis (n=121) from the Optimizing Patient Experience and Response to Topical Analgesics (OPERA) Study that evaluated changes in opioid use, other concurrrent medication use, and pain severity and interference in opioid-experienced patients who received topical analgesics for chronic pain. One of four classes of topical prescription ingredients—diclofenac, ketoprofen, flurbiprofen, or other non-NSAID formulation— were prescribed and patients were followed up at 3 and 6 months.
Of the chronic pain patients taking opioids at study initiation, 49% in the 3-month and 56% in the 6-month groups reported complete discontinuation of opioids. Moreover, 31% of patients in the 3-month and 30% at the 6-month follow-up reported no use of any pain medications.
Use of concurrent medications were lowered by 65% after 3 months and by 74% at 6 months. Study authors also reported statistically significant reductions in pain severity and interference scores from baseline in the 3-month and 6-month groups.
Based on the analysis, the authors were able to conclude that 3- and 6-months treatment with topical analgesics effectively cut opioid and other concurrent medications use among opioid-experienced patients with chronic pain, and reduced pain severity and interference.
“In addition to previous results showing that topical analgesics were associated with reductions of up to 60% in the use of concurrent pain medications, including oral opioid analgesics, we now have data reflecting discontinuation of opioids after being treated with this therapy for 3- and 6-months. Especially in today’s environment, identifying treatments other than opioids for clinicians to prescribe to their pain patients has become a priority,” concluded lead author Jeffrey A. Gudin, Englewood Hospital and Medical Center, Englewood, NJ.
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