Considerations in selecting rapid-onset opioids for the management of breakthrough pain

Abstract

Michael Perelman, Suzan LeakeArchimedes Pharma, Bedminister, NJ, USAWe read with great interest the recent publication by Smith.1 This article provides a valuable perspective on the selection of an agent to manage breakthrough pain. Smith recognizes the importance of a fast onset-of-action and the identification by Farrar et al2 of a 33% (often ≥2 point) change in the pain intensity difference as a measure of a ‘clinically important improvement’. For these reasons, Smith focuses on the various transmucosal fentanyl formulations that offer a rapid onset and he provides a nice summary of the key features of each of the available products.View original paper by Howard S Smith.