Treatment of chronic pain with not much used opioid, buprenorphine
The clinical value of buprenorphine has been clearly established but still it is not very commonly used drug in treating chronic pain. Ceiling effect or Bell shaped curve witnessed for analgesia in preclinical studies and possible withdrawal issues on combining with marketed µ-agonists continue to deter progress in expanding full potential of buprenorphine in cancer and non-cancer pain treatment.
Increasing evidence from clinical studies and inferences drawn by a panel of experts strongly favors safety and effectiveness of buprenorphine than marketed opioids. None of the clinical studies has reported ceiling on analgesic effect.
Buprenorphine offers a complex but somewhat unique pharmacology and pharmacokinetics profile than other opioids. Buprenorphine can easily be combined with other µ-receptor opioids for superfluous effectiveness. Transdermal delivery products of buprenorphine are amongst the favorites for the management of pain but researchers are trying to find out new delivery routes for the treatment of both opioid dependence and chronic pain.