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STAMFORD, Conn., May 9, 2013 – Purdue Pharma L.P. will present a poster reviewing selected guidelines issued by North American professional societies or federal and state governments to raise awareness of the variability in currently available conversion factors for oral opioids. These data will be presented during the American Pain Society’s annual meeting May 8-11 in New Orleans.
The objective of the analysis sought to describe concerns identified with conversion estimates, including overestimating “equianalgesic” doses and failure to consider incomplete cross tolerance, the likely pain trajectory, comorbidities, concomitant medicines and inter-patient variability as clinicians often rely on published conversion tables to convert between opioids or administration routes for patients with pain. Sources include the Full Prescribing Information for specific products, or clinical guidelines from professional societies, advocacy organizations, or government entities.
Most conversion estimates are based on single-dose, relative potency studies, not conversion in ongoing care. There are conflicting recommendations in the literature and no uniformly accepted conversion ratios.
The analysis found that variability exists in the recommendations for conversion ratios, as well as for dose reductions to account for incomplete cross-tolerance between opioids and whether or how to consider various patient factors at the time of conversion. Moreover, the analysis found that there were numerous sources for the opioid conversion ratios across guidelines, which varied in publication type, how recent information is, numbers of subjects, and study design. Most studies were not well-controlled, multiple-dose trials in chronic pain patients.
It is important that practitioners are aware of these clinically-meaningful limitations and consider the reliability and applicability of these conversion ratios to the setting of chronic opioid administration. Likewise, legislators and regulators contemplating the use of conversion ratios in implementing pain policies should understand the unresolved variability and lack of bi-directionality in conversion tables.
“The need commonly arises for clinicians to convert between different types of opioids or administration routes for patients with chronic pain, and they must often rely on published conversion tables to do so,” said Gary L. Stiles, M.D., vice president of research and development at Purdue Pharma. “Because of this, it is imperative that healthcare professionals and policy makers, alike, are aware of these clinically meaningful limitations and consider the reliability and applicability of these conversion ratios in opioid administration and in implementing pain policies.”
Details of the scheduled poster presentation at the APS meeting follow:
? Thursday, May 9, 9:30-11:00 a.m., Poster 193 “Review of opioid conversion recommendations from select clinical practice guidelines: all are not equal.” J. Erensen, J. Haddox, N. Crudele, M. Kwarcinski
The authors of this poster are all full-time employees of Purdue Pharma L.P. and the review was funded by the Company.
About Purdue Pharma L.P.
Purdue Pharma L.P. and its associated U.S. companies are privately held pharmaceutical companies known for pioneering research on persistent pain. Headquartered in Stamford, CT, Purdue Pharma is engaged in the research, development, production and distribution of both prescription and over-the-counter medicines and hospital products. Additional information about Purdue can be found at www.purduepharma.com.
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