[Fentanyl-TTS in the treatment of pain caused by arthrosis]

Efficacy and tolerability of analgesic treatment with fentanyl-TTS (Durogesic) for pain caused by arthrosis was investigated.

Treatment with fentanyl-TTS was started for the first time in patients with severe pain caused by coxarthrosis and/or gonarthrosis and was prospectively documented for 30 days. Pain was assessed by the patient with an 11-step numerical analogue scale and by the physician with 5 questions (5-step scale) adapted from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

A total of 243 patients (166 women, 77 men) with a mean age of 67 years (range 28 - 94) was treated. In the patient's rating, pain at rest as well as in motion decreased significantly from 6.4 +/- 2.1 to 2.9 +/- 2.0 and from 8.1 +/- 1.5 to 4.2 +/- 21, respectively (p < 0.001 for both comparisons). The sum score for the 5 questions with a detailed pain assessment by the physician decreased from 18.8 +/- 3.2 to 11.2 +/- 42 (p < 0.001). A significant pain reduction was also observed for each of the 5 single questions. At the end of observation the proportions of patients with no pain or impairment under different conditions were 5 % (climbing stairs), 14 % (walking), 26 % (standing), 33 % (lying/sitting), and 44 % (sleeping). The most common adverse events were nausea, vomiting, obstipation, and dizziness. Treatment with fentanyl-TTS was usually well-tolerated.

Severe pain caused by arthrosis can be well treated with fentanyl-TTS with a favourable safety profile.