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Journal Article Research Support, Non-U.S. Gov't Ppublish 16 citations

PubMed: 34480564 DOI: 10.1093/pm/pnab263

Effectiveness, Safety, and Tolerability of Nabiximols Oromucosal Spray vs Typical Oral Long-Acting Opioid Analgesics in Patients with Severe Neuropathic Back Pain: Analysis of 6-Month Real-World Data from the German Pain e-Registry.

Pain Med 23(4):745-760

Authors: Michael A Ueberall, Carlos Vila Silván, Ute Essner, Gerhard H H Mueller-Schwefe

Affiliations

  • Institute of Neurological Sciences, Nuernberg, Germany.
  • Global Medical Affairs, Almirall S.A. Barcelona, Spain.
  • O. Meany Consultancy GmbH, Hamburg, Germany.
  • Schmerz- und Palliativzentrum Göppingen, Göppingen, Germany.

Abstract

OBJECTIVE

To compare the effectiveness, safety, and tolerability of add-on nabiximols (NBX) oromucosal spray vs typical oral long-acting opioid (LAO) analgesics in patients with severe (± chronic) peripheral neuropathic back pain poorly responsive to other treatments.

METHODS

Retrospective analysis of anonymized, propensity score-matched data from the German Pain e-Registry of adult outpatients who initiated NBX or LAO between March 2017 and March 2020.

RESULTS

Data were analyzed from propensity score-matched patients treated with NBX (n = 655) or LAO (n = 655): mean age ≈51 years; 57% female; mean pain duration ≈2.6 years; chronic pain 61%; severe dysfunctional pain 93%. At 6 months, NBX was noninferior to LAO for overall symptom relief, based on the least-squares mean difference between cohorts in change from baseline in patient-reported, pain-related aggregated nine-item scale scores (-27.84%; 95% confidence interval [CI] -29.71 to -25.96; P < 0.001) and individual pain-related scale scores. Subsequent prespecified superiority analysis of the primary endpoint showed that NBX was superior to LAO: all secondary endpoints measuring symptoms of pain and physical function improved significantly with NBX and LAO, with between-group differences favoring NBX (all P < 0.001). Fewer patients treated with NBX than LAO experienced treatment-related adverse events (25.5% vs 76.0%; P < 0.001) or discontinued treatment because of treatment-related adverse events (7.9% vs 29.3%; P < 0.001).

CONCLUSION

Within study limitations (e.g., observational design, all potential biases), add-on NBX was superior to and better tolerated than add-on treatment with typical oral LAO analgesics in patients with neuropathic back pain inadequately controlled by recommended/established systemic therapies.

MeSH

Registries, Safety, Pain, Pain Management, Analgesics, Opioid, Propensity Score, Drug-Related Side Effects And Adverse Reactions, Analgesics, Therapeutics, Back Pain

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