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Drugs
Published in: Drugs 12/2018

01-08-2018 | Review Article

Treating Chronic Pain: An Overview of Clinical Studies Centered on the Buprenorphine Option

Authors: Mellar P. Davis, Gavril Pasternak, Bertrand Behm

Published in: Drugs | Issue 12/2018

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Abstract

The buprenorphine receptor binding profile is unique in that it binds to all three major opioid receptors (mu, kappa, delta), and also binds to the orphan-like receptor, the receptor for orphanin FQ/nociceptin, with lower affinity. Within the mu receptor group, buprenorphine analgesia in rodents is dependent on the recently discovered arylepoxamide receptor target in brain, which involves a truncated 6-transmembrane mu receptor gene protein, distinguishing itself from morphine and most other mu opioids. Although originally designed as an analgesic, buprenorphine has mainly been used for opioid maintenance therapy and only now is increasingly recognized as an effective analgesic with an improved therapeutic index relative to certain potent opioids. Albeit a second-, third-, or fourth-line analgesic, buprenorphine is a reasonable choice in certain clinical situations. Transdermal patches and buccal film formulations are now commercially available as analgesics. This review discusses buprenorphine pharmacodynamics and pharmacokinetics, use in certain populations, and provides a synopsis of systematic reviews and randomized analgesic trials. We briefly discuss postoperative management in patients receiving buprenorphine maintenance therapy, opioid equivalence to buprenorphine, rotations to buprenorphine from other opioids, and clinical relevance of buprenorphine-related QTc interval changes.
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Metadata
Title
Treating Chronic Pain: An Overview of Clinical Studies Centered on the Buprenorphine Option
Authors
Mellar P. Davis
Gavril Pasternak
Bertrand Behm
Publication date
01-08-2018
Publisher
Springer International Publishing
Published in
Drugs / Issue 12/2018
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-018-0953-z

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