Buprenorphine for treating cancer pain

Buprenorphine produced good pain relief for most people with moderate or severe cancer pain, but its role in the treatment of cancer pain is still unclear. Many patients with cancer experience moderate‐to‐severe pain that requires treatment with strong pain relief medicines. Buprenorphine and morphine are examples of strong pain relief medicines that are used for the relief of cancer pain. However, strong pain relief medicines are not effective for pain in all patients nor are they well‐tolerated by all patients. The aim of this Cochrane review is to assess whether buprenorphine is associated with better, worse or equal pain relief and tolerability compared to other pain relief medicines for patients with cancer pain. We searched the literature on 20 Janurary 2015 and found 19 relevant studies with a total of 1421 patients that compared different types of buprenorphine to each other or to other strong pain relief medicines or to placebo. The reported average ages of the patients ranged from 49.1 years to 67.16 years, and the duration of the studies ranged from single dose treatment to six months. Generally, the studies showed that buprenorphine is an effective strong pain relief medicine that in some cases may be slightly better than other strong pain relief medicines. However, the evidence provided by these studies were of very low quality and on the basis of the available evidence, it is still hard to say where buprenorphine fits in in the treatment of cancer pain with strong opioids. All the strong pain relief medicines examined in the studies are also associated with a number of unwanted effects, such as vomiting, constipation and drowsiness