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Efficacy and Safety of Prophylactic Opioid Rescue for Breakthrough Pain Due to Body Movement: A Multicenter

Ryo Taguchi¹, Rei Tanaka², Eiji Kose^3,4

¹Department of Pharmacy, Shizuoka Cancer Center, 411-8777 Shizuoka, Japan.

|April 30, 2026

Abstract

Background:

Prophylactic opioid rescue therapy is often used to manage cancer-related pain. However, the effect of prophylactic rescue therapy in suppressing increases in breakthrough pain due to body movements has not yet been investigated. Therefore, this study aimed to compare the efficacy and safety of prophylactic rescue therapy before and after administration.

Methods:

This multicenter, retrospective survey was conducted in Japan. Participants were patients with cancer who received prophylactic strong opioid rescue therapy for the first time. The primary endpoint was the suppression of an increase in pain, assessed using a Numerical Rating Scale (NRS), before and after administration of prophylactic rescue due to body movement.

Results:

The overall analysis (193 cases) showed that prophylactic rescue suppressed the increase in the median NRS value by 3.00 (interquartile range: 1.00-4.00, p < 0.001). In addition, subgroup analysis by purpose (meals/bathing/rehabilitation/radiation therapy/others) also showed a significant reduction in the increase in NRS, with all categories exhibiting a decrease of 2.00 or more.

Conclusions:

Prophylactic opioid rescue with appropriate patient selection can effectively suppress breakthrough pain caused by body movement.

Keywords:

analgesics, opioid breakthrough pain cancer pain pain management

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