Network meta-analysis ranks opioid options for breakthrough cancer pain

This systematic review with network meta-analysis pooled 23 randomized controlled trials comparing opioid formulations and routes for breakthrough cancer pain. Compared with placebo, intravenous or subcutaneous morphine and intranasal or sublingual fentanyl tablets showed the greatest pain intensity difference at 15 minutes, with sublingual fentanyl tablets performing comparably to intravenous or subcutaneous morphine by 30 minutes. The authors note the overall quality of evidence is poor, largely derived from phase III approval trials, with a high risk of publication bias.

Most relevant for: Patients experiencing breakthrough pain episodes in the context of cancer.

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