Table 11GRADE profile summary comparing transdermal fentanyl patch with transdermal buprenorphine patch for first-line treatment of pain in patients for whom oral opioids are not suitable

Quality assessmentSummary of findings
No of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsBuprenorphine patchFentanyl patchRelative (95% CI)Absolute
Pain
1aRandomised trialsSeriousbNo serious inconsistencyNo serious indirectnessVery seriouscNone1616No difference reportedVERY LOW
Side effects
2dRandomised trialsVery seriouseNo serious inconsistencySeriousfNo serious imprecisionNone7771Some differences reported.
See also text in section 3.5.2
VERY LOW
a
b

RCT published in abstract form only, so not possible to fully appraise.

c

N = 32.

d
e

Studies either published in abstract form only or using randomly selected patients already receiving treatment drugs.

f

Not all first-line treatment.

Abbreviations: CI, confidence interval.

From: 3, Evidence review and recommendations

Cover of Opioids in Palliative Care
Opioids in Palliative Care: Safe and Effective Prescribing of Strong Opioids for Pain in Palliative Care of Adults.
NICE Clinical Guidelines, No. 140.
National Collaborating Centre for Cancer (UK).
Copyright 2012, © National Collaborating Centre for Cancer.

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