Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration
ObjectiveThe aim of this study was to establish a pharmacodynamic model of tapentadol analgesia under dose titration conditions, to quantitatively analyze the time-effect relationship of the drug, and to identify relevant influencing factors. This model is intended to provide a pharmacodynamic refer...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pain Research |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2024.1474529/full |
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| author | Liang Xin Haoxiang Zhu Haoxiang Zhu Suping Niu Xie Han Hongxian Pang Jiangfan Li Ye Hu Xuhong Wang Lujin Li Lujin Li Yi Fang |
| author_facet | Liang Xin Haoxiang Zhu Haoxiang Zhu Suping Niu Xie Han Hongxian Pang Jiangfan Li Ye Hu Xuhong Wang Lujin Li Lujin Li Yi Fang |
| author_sort | Liang Xin |
| collection | DOAJ |
| description | ObjectiveThe aim of this study was to establish a pharmacodynamic model of tapentadol analgesia under dose titration conditions, to quantitatively analyze the time-effect relationship of the drug, and to identify relevant influencing factors. This model is intended to provide a pharmacodynamic reference for designing rational tapentadol dose titration schemes in clinical research.MethodsRandomized controlled trials assessing the efficacy of tapentadol in the management of chronic pain were retrieved from public databases (PubMed and EMBASE). A time-effect relationship model of the percent change in Numerical Rating Scale (NRS) scores post-tapentadol intervention from baseline was constructed, along with a covariate model to identify factors significantly impacting the analgesic effects of tapentadol. Potential influencing factors that were clinically significant but not included in the final covariate model were examined for their impact trends on tapentadol analgesia through subgroup analysis.ResultsA total of 16 studies involving 4,508 participants were included in the analysis. Covariate analysis indicated that age significantly affected the maximum reduction in NRS scores following tapentadol treatment, with the reduction rate being 40.9% for patients aged 45 and 60.7% for those aged 65, suggesting that older patients have a higher demand for pain relief. Furthermore, studies published after 2014 and placebo-controlled trials showed a slower rate of NRS reduction, indicating a more cautious approach to tapentadol dosing titration post the U.S. opioid crisis and in placebo-controlled contexts. Additionally, subgroup analysis suggested that higher titration doses, higher baseline NRS levels, the use of extended-release tapentadol, and a smaller proportion of male participants were trends associated with better analgesic effects, although the differences were not statistically significant. Moreover, the study found that tapentadol was significantly more effective in treating lower back pain compared to non-lower back pain.ConclusionThis research successfully developed a pharmacodynamic model for dose-titrated tapentadol administration, which can simulate the temporal changes in analgesic effects of tapentadol across different clinical scenarios. This model can guide the formulation of dosing titration protocols for tapentadol in clinical research.Systematic Review Registrationhttps://inplasy.com/inplasy-2024-5-0014/ |
| format | Article |
| id | doaj-art-da202b3223e74415b081c697fc5debc2 |
| institution | Kabale University |
| issn | 2673-561X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pain Research |
| spelling | doaj-art-da202b3223e74415b081c697fc5debc22025-01-17T06:50:56ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2025-01-01510.3389/fpain.2024.14745291474529Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titrationLiang Xin0Haoxiang Zhu1Haoxiang Zhu2Suping Niu3Xie Han4Hongxian Pang5Jiangfan Li6Ye Hu7Xuhong Wang8Lujin Li9Lujin Li10Yi Fang11Medical Institution Conducting Clinical Trials for Human Used Drug, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaCenter for Pharmacometrics, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaState Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaClinical Trial Institution, Peking University People’s Hospital, Beijing, ChinaDepartment of Pharmacy, Nanjing Drum Tower Hospital, Nanjing, Jiangsu, ChinaClinical Pharmacology Department, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaClinical Pharmacology Department, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaClinical Pharmacology Department, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaClinical Pharmacology Department, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaCenter for Pharmacometrics, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaState Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, ChinaClinical Trial Institution, Peking University People’s Hospital, Beijing, ChinaObjectiveThe aim of this study was to establish a pharmacodynamic model of tapentadol analgesia under dose titration conditions, to quantitatively analyze the time-effect relationship of the drug, and to identify relevant influencing factors. This model is intended to provide a pharmacodynamic reference for designing rational tapentadol dose titration schemes in clinical research.MethodsRandomized controlled trials assessing the efficacy of tapentadol in the management of chronic pain were retrieved from public databases (PubMed and EMBASE). A time-effect relationship model of the percent change in Numerical Rating Scale (NRS) scores post-tapentadol intervention from baseline was constructed, along with a covariate model to identify factors significantly impacting the analgesic effects of tapentadol. Potential influencing factors that were clinically significant but not included in the final covariate model were examined for their impact trends on tapentadol analgesia through subgroup analysis.ResultsA total of 16 studies involving 4,508 participants were included in the analysis. Covariate analysis indicated that age significantly affected the maximum reduction in NRS scores following tapentadol treatment, with the reduction rate being 40.9% for patients aged 45 and 60.7% for those aged 65, suggesting that older patients have a higher demand for pain relief. Furthermore, studies published after 2014 and placebo-controlled trials showed a slower rate of NRS reduction, indicating a more cautious approach to tapentadol dosing titration post the U.S. opioid crisis and in placebo-controlled contexts. Additionally, subgroup analysis suggested that higher titration doses, higher baseline NRS levels, the use of extended-release tapentadol, and a smaller proportion of male participants were trends associated with better analgesic effects, although the differences were not statistically significant. Moreover, the study found that tapentadol was significantly more effective in treating lower back pain compared to non-lower back pain.ConclusionThis research successfully developed a pharmacodynamic model for dose-titrated tapentadol administration, which can simulate the temporal changes in analgesic effects of tapentadol across different clinical scenarios. This model can guide the formulation of dosing titration protocols for tapentadol in clinical research.Systematic Review Registrationhttps://inplasy.com/inplasy-2024-5-0014/https://www.frontiersin.org/articles/10.3389/fpain.2024.1474529/fullchronic painopioidstapentadolmodel-based meta-analysispharmacodynamic |
| spellingShingle | Liang Xin Haoxiang Zhu Haoxiang Zhu Suping Niu Xie Han Hongxian Pang Jiangfan Li Ye Hu Xuhong Wang Lujin Li Lujin Li Yi Fang Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration Frontiers in Pain Research chronic pain opioids tapentadol model-based meta-analysis pharmacodynamic |
| title | Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration |
| title_full | Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration |
| title_fullStr | Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration |
| title_full_unstemmed | Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration |
| title_short | Pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration |
| title_sort | pharmacodynamic characteristics and influencing factors of tapentadol for chronic pain relief under dose titration |
| topic | chronic pain opioids tapentadol model-based meta-analysis pharmacodynamic |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2024.1474529/full |
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