Effect Of Fentanyl Transdermal Patches In The Treatment Of Moderate-to-severe Cancer Pain:A Meta-analysis

Objective To evaluate the effectiveness and safety of fentanyl transdermal patches and morphine sustained-release tablets for patients with moderate-to-severe cancer pain.Methods PubMed?Mbase?Cochrane Library?CNKI?WangFang Data?VIP and CBM were searched to collect all published randomized controlled trials(RCTS)comparing fentanyl transcutaneous patches for moderate to severe cancer pain before May 2019.Literature screening,data extraction and cross-checking were carried out by 2 evaluators independently.The data analyses was performed by RevMan 5.30.Result A total of 15 RCTS were included in the study,involving1353 patients.The results of meta-analysis showed : The effective rate of fentanyl transdermal patches group was similar to that of morphine controlled release tablets [OR=0.90;95%CI(0.65,1.26);P=0.55].The incidence of nausea [OR=0.42;95%CI(0.32,0.56);P<0.00001],vomiting[OR=0.23;95%CI(0.18,0.31);P<0.00001],constipation[OR=0.56;95%CI(0.39,0.81);P=0.002],drowsiness and dizziness[OR=0.48;95%Cl(0.33,0.69);P<0.0001] in fentanyl group was lower than that of morphine group.The incidence of itchy skin in the fentanyl group was significantly higher than that in the morphine group [OR=3.51;95% CI(1.97,6.23);P<0.0001].Conclusion The current research results show that the transdermal fentanyl patch can effectively improve the pain of patients with moderate to severe cancer pain.The incidence of adverse reactions including nausea,vomiting,constipation,dizziness and drowsiness was significantly lower than that of the control group.The incidence of itchy skin is higher compared with morphine group,but attach parts replacement can be obviously relieve this symptom,therefore,fentanyl transdermal patches can be safe and effective therapy for patients with moderate-to-severe cancer pain.