Sufentanil sublingual tablets good at safely relieving moderate-to-severe acute pain

USA: Short-term administration of sufentanil sublingual tablets (SSTs) is well-tolerated in patients with moderate-to-severe acute pain with not so severe adverse events (AEs), according to findings from Pain Management journal.

Despite advances in pain treatment, acute pain management remains inadequate and 20-40% of the patients still experience severe pain after surgery. It is also the most common complaint of patients presenting to the emergency department. Intravenous (IV) opioid, such as morphine or hydromorphone, is commonly used for the management of acute to severe pain. But this requires the time and cost of initiating IV access and can result in undesirable side effects such as respiratory depression, vomiting and nausea.

Sufentanil is a synthetic opioid analgesic which is characterized by high selectivity and affinity for mu-opioid receptors. In contrast to more commonly used opioids, sufentanil has no active metabolites. Also, it is more potent and twice as lipophilic as fentanyl allowing for a small dosage form and rapid analgesia onset on sublingual administration. Therefore, SSTs may be a viable noninvasive alternative for the treatment of acute to severe pain.

James R Miner, Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, USA, and colleagues evaluated the pooled safety of sufentanil sublingual tablets (SSTs) administered at 30-mcg dose equivalents over ≤72 h for moderate-to-severe acute pain management in medically supervised settings.

Safety data from SST 30 mcg Phase III studies were pooled with an additional patient subset from studies in which two SST 15 mcg were self-administered within 20–25 min (30-mcg dose-equivalent).

Analyses included 804 patients. Median (range) SST 30-mcg dosing over 24 h was 7.0 (1–15) tablets.

Also Read:Intranasal sufentanil as effective as intravenous morphine for acute pain

Key findings include:

• Adverse events (AEs) were experienced by 60.5% (SST) and 61.4% (placebo) and treatment-related AEs by 43.8% (SST) and 33.5% (placebo; 10.3% difference; 95% CI: 2.0–18.6) of patients.


• No dose-dependent increase in oxygen desaturation was observed with SST.

Also Read:FDA approves sublingual sufentanil for acute pain

"While a significantly greater proportion of patients in the SST group compared with the placebo group experienced ≥1 treatment-related AE, the overall findings from the pooled analysis support that short-term (≤72 h) administration of SST is well tolerated–with most AEs considered mild or moderate in severity–for the treatment of moderate-to-severe acute pain in medically supervised settings," concluded the authors.

To read the complete study follow the link: https://doi.org/10.2217/pmt-2018-0090