Novel formulations and routes of administration for opioids in the treatment of breakthrough pain

The interest for assessment and treatment of breakthrough pain (BTP) has been increasing, probably due to a growing attentiveness towards the problems associated with BTP, but also encouraged by the development of novel pharmaceutical formulations specially intended for the treatment of BTP. BTP can be described as ‘an episodic increase in pain intensity over a stable and adequately managed baseline pain’. BTP is a heterogeneous condition, and the most optimal treatment is influenced by a number of different pain-related factors, including the etiology of the pain (cancer or noncancer pain), the pathophysiology of the pain (nociceptive or neuropathic), the characteristics of the pain (type, frequency, and duration). Furthermore, it will depend on various patient-related conditions, such as stage of disease, performance status, compliance and the acceptability of different interventions. Treatment of BTP should be individualized to fit the special needs of the single individual patient. The optimal opioid ...