Background and aims: Chronic severe pain is challenging, especially because of the adverse effects of commonly used classical opioids. Tapentadol (TAP) is an unique opioid effective against both nociceptive and neuropathic components of chronic pain and well-tolerated. We analyzed the impact of TAP on Quality-of-Life Impairment by Pain (QLIP) and sick leave in patients included in GPPR.
Methods: This was a retrospective longitudinal analysis, using propensity scoring for age, gender and chronification and graded pain scale (von Korff), of biometrically/medically-comparable cohorts of patients with chronic spine/low back pain receiving TAP after non-opioids (WHO-group 1), low-potency opioids (WHO-group 2) or high-potency opioids (WHO-group 3). Quality-of-Life Impairment by Pain (QLIP)  and pain-related sick leave were evaluated as secondary efficacy endpoints.
Results: Of 174,222 patients in the GPPR, 48,506 (27.8%) received WHO-specified analgesics, with 10,389 (6%) receiving TAP. Compared with baseline, patients receiving TAP after WHO-group 1 analgesics had greater improvement in QLIP (72.6%) and less sick leave (-76.8%) compared with WHO-group 2 and 3 patients [QLIP 57.1 and 43.7%; sick leave -48.9 and -37.0%, respectively]. Generally group 1 exhibited higher/better responses than group 2, which was better than group 3.
Conclusions: Earlier switching to TAP from WHO 1&2 analgesics in chronic pain was associated with improved QLIP and less sick leave compared with its use later in the course of the disease.

THE IMPACT OF TAPENTADOL ON QUALITY-OF-LIFE AND SICK LEAVE: REAL-WORLD DATA FROM THE GERMAN PAIN PRACTICE REGISTRY (GPPR)