Efficacy of transdermal buprenorphine patch for managing withdrawal symptoms in patients with cancer physically dependent on prescription opioids.
Jung Hun Kang, Kyung Hee Lee, Seok Jae Huh, Seong-Hoon Shin, Il Hwan Kim, In Gyu Hwang, Dong-Hoe Koo, Dongyun Lee, Su-Jin Koh, Seyoung Seo, Guk Jin Lee, Sang Hoon Chun, Jun Ho Ji, Sung Yong Oh, Jung Woo Choi, Se-Il Go
Author Information
Jung Hun Kang: Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.
Kyung Hee Lee: Department of Hematology-Oncology, Yeungnam University College of Medicine, Daegu, Korea.
Seok Jae Huh: Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Seong-Hoon Shin: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Il Hwan Kim: Division of Oncology, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
In Gyu Hwang: Division of Hematology/Oncology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Dong-Hoe Koo: Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Dongyun Lee: Department of Psychiatry, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea.
Su-Jin Koh: Department of Hematology and Oncology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea.
Seyoung Seo: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Guk Jin Lee: Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
Sang Hoon Chun: Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
Jun Ho Ji: Division of Hematology-Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Sung Yong Oh: Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
Jung Woo Choi: Department of Internal Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.
Se-Il Go: Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea. ORCID
BACKGROUND: The physical dependence on prescription opioids among cancer survivors remains an under-investigated area, with a scarcity of well-designed prospective studies. METHODS: This single-arm, phase-2 clinical trial in Korea assessed the efficacy and safety of a transdermal buprenorphine patch (TBP) in managing physical dependence on prescription opioids in cancer survivors, as confirmed through the DSM-5 criteria or psychiatric consultation for opioid withdrawal. This study involved a 4-phase treatment protocol of screening, induction/stabilization, discontinuation, and monitoring. The primary outcome was the rate of successful opioid discontinuation, as measured by a negative urine-drug screening at 8 weeks. Key secondary outcomes included the resumption of prescribed opioids, changes in both the Clinical Opioid Withdrawal Scale (COWS) and morphine equivalent daily dose (MEDD), and assessments related to the psychological and physiological aspects of dependence and safety. RESULTS: Thirty-one participants were enrolled. In the intention-to-treat population, the success rate of opioid discontinuation was 58%, with only 2 participants experiencing a resumption of prescribed opioids. Significant reductions were observed in MEDD, which decreased from 98 to 26 mg/day (P���<���.001), and COWS scores, which decreased from 5.5 to 2.8 (P���<���.001). Desire to use opioids reduced from 7.0 to 3.0 on a 10-point numeric rating scale (P���<���.001). Toxicities related to TBP were mild and manageable, without severe precipitated withdrawal symptoms. CONCLUSION: TBP may be considered as an alternative therapeutic option in cancer survivors physically dependent on prescription opioids, especially where sublingual formulations are unavailable.
