Transdermal Pain Medications- Results of the OPERA Study

Topical/Transdermal Analgesics

Topical or transdermal analgesics are medications that are used to help control pain by applying them to the surface of tissues rather than taking them by mouth, injection, or other route.

Topical analgesics have many advantages pain medications that are administered by the systemic route.  One of the main advantages is a lower level of systemic concentration and side effects. Additionally, there is often significantly decreased drug-drug interaction with transdermal medications.

Opioid Crisis

Currently, the United States is experiencing an increasing number of opiate related deaths due to accidental drug overdose.  Many of these accidental overdoses occur in individuals who are using prescription opiate medications in an attempt to control chronic pain.  Currently, in the United States of America, over 100 million people suffer with chronic noncancer pain.  In fact, this is one of the most common reasons that people seek medical attention. In 2014 there were 47,055 deaths due to drug overdoses.  Of those, 10,574 deaths related to heroin. An astonishing 18,893 of these overdose deaths were related to prescription pain medications.  In response to this escalating rate of deaths related to opiates, efforts are being made to find solutions to treat pain that reduce or eliminate the need to utilize opiate medications. one of the solutions being investigated is the utilization of transdermal/topical pain medications.

OPERA Study

A recent study published by Clarity Science demonstrates that transdermal pain medications can have a significant impact on the amount of opiate medications that are necessary to control pain.

The name of this study is the OPERA Study. “OPERA” stands for Optimizing Patient Experience and Response to Topical Analgesics. The results of this study have been presented at multiple national conferences as well as such as the 4th Annual International Conference on Opioids at Harvard Medical School, the American Academy of Pain Management’s 26 Annual Clinical Meeting, and PAIN Week National Conference 2015.  in national medical publications such as the “Journal of Pain Research” and “Postgraduate Medicine”.

Additionally, this study demonstrated a significant decrease in the use of over-the-counter and prescription nonsteroidal anti-inflammatory medications (NSAID’s).  While not as common as opioid -related deaths, NSAID’s do have significant risks. The most commonly recognized risk is the risk of G.I. bleeding.  It is been estimated that approximately 3200 deaths occur annually secondary to NSAID -related G.I. bleeding.  Additionally, chronic NSAID use is thought to significantly increase cardiovascular risks from heart attack, congestive heart failure, and stroke.  Chronic NSAID use can also increase the risk of or worsen kidney disease/failure.

The OPERA Study included 631 patients over the course of six months.  The study found that the utilization of topical/transdermal medications for pain control resulted in statistically significant (P <0.001) decrease in pain severity and pain interference scores.  These results indicate that there is less than one in 1000 chances that the results were due to random occurrence.

Results

Some of the key findings of the study are as follows:

  • 27.5% reduction in opioid use
  • 50% reduction in over-the-counter and NSAID use
  • 64.1% reduction in prescription anti-inflammatory use
  • 20.7% decrease in pain associated with arthritis
  • 21.5% decrease in pain associated with neuropathy and/or radiculopathy
  • Reduction in reported pain severity, symptoms, and complaints
  • Reduced interference in activity, mood, sleep, interpersonal relations, and the life enjoyment secondary to pain.
  • Preference of topical/transdermal medications when compared with oral medication
  • 92% satisfaction rate with transdermal medication
  • 99.5% of patients had no side effects with transdermal medication and of those that did have side effects, no serious adverse effects occurred.

The topical anti-inflammatories diclofenac, flurbiprofen, and ketoprofen were compared.  Of these three anti-inflammatories, that’s open act appeared to perform significantly better than the other two.

The large majority of subjects the transdermal medications to be convenient, easy to apply, and 76% preferred them over oral medication.  92% of subjects were either very satisfied or somewhat satisfied with the transdermal medications.

In summary, the findings of the OPERA Study concluded that transdermal/topical analgesics/pain medications are effective, decrease the use of more hazardous medications such as opioids and NSAID’s, have very low side effect profiles, and have high levels of patient satisfaction.

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