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Last Updated: March 26, 2026

CLINICAL TRIALS PROFILE FOR ABSTRAL


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All Clinical Trials for ABSTRAL

Trial ID Title Status Sponsor Phase Start Date Summary
NCT01158820 ↗ Alternative Sedation During Bronchoscopy Completed Hospira, Inc. Phase 4 2010-06-01 This protocol hopes to determine whether the use of dexmedetomidine-ketamine can reduce the use of standard of care fentanyl-midazolam sedation during bronchoscopy. This may result in less respiratory depression while providing better compliance with the procedure.
NCT01158820 ↗ Alternative Sedation During Bronchoscopy Completed Hospira, now a wholly owned subsidiary of Pfizer Phase 4 2010-06-01 This protocol hopes to determine whether the use of dexmedetomidine-ketamine can reduce the use of standard of care fentanyl-midazolam sedation during bronchoscopy. This may result in less respiratory depression while providing better compliance with the procedure.
NCT01158820 ↗ Alternative Sedation During Bronchoscopy Completed University of Pennsylvania Phase 4 2010-06-01 This protocol hopes to determine whether the use of dexmedetomidine-ketamine can reduce the use of standard of care fentanyl-midazolam sedation during bronchoscopy. This may result in less respiratory depression while providing better compliance with the procedure.
NCT01315886 ↗ Conversion From Fast Acting Oral Opioids to Abstral® Terminated Orexo AB Phase 4 2011-02-21 The purpose of this study is to evaluate safety and efficacy when using a novel dose conversion strategy to switch from immediate release oral opioids to sublingual (SL) fentanyl (Abstral) for treatment of breakthrough cancer pain (BTcP).
NCT01604187 ↗ Procedural Pain Treatment With Transmucosal Sublingual Fentanyl Tablet in Colonoscopy Patients Completed Turku University Hospital Phase 4 2012-04-01 Colonoscopy is generally considered an invasive procedure that causes remarkable pain to the patient. The pain associated with the procedure is not caused by the insertion of the scope but from inflating of the colon in order to do the inspection. It has been shown that colonoscopy can be performed successfully without sedation (Leung, 2010), but many patients feel discomfort during the procedure. Factors predicting a painful colonoscopy are female-gender, degree of patient nervousness and the technical difficulty of the colonoscopy (Ylinen et al. 2009). Also age under 40, previous abdominal surgery and use of sedation are associated with painful colonoscopy ( Seip et al. 2009). Most often sedation and/or analgesia are achieved by administering a benzodiazepine or a combination of a benzodiazepine and an opioid (Fanti et al. 2009, Maskelar et al. 2009,), dexmedetomidine (Dere et al. 2009) or by using non-pharmacologic methods (Amer-Cuenca et al. 2011). Tramadol as monotherapy did not significantly decrease pain intensity or endoscopist's evaluation of colonoscopy (Grossi et al. 2004). Currently, intravenous midazolam is the drug used most commonly to introduce some sedation for colonoscopy. Intravenous sedation definitely increases the cost of procedure; drug administration, need for pulse oximetry monitoring and the need for follow-up after the procedure make colonoscopy sometimes expensive and troublesome. It has also been shown, that low-dose midazolam neither relieves discomfort nor makes patients forget it (Elphick et al. 2009). Fentanyl is a short-acting opioid widely used in anesthesia management. Transmucosal sublingual formulation of fentanyl has been developed to further improve the management of pain. When administered as a sublingual fast-dissolving tablet (Abstral®) that is placed under the tongue, the effects is fast and predictable. Its active ingredient is absorbed by the body through the mucous membrane. After administration of buccal fentanyl maximum plasma drug concentration was measured after 25 minutes (Darwish et al. 2011). Plasma fentanyl concentrations versus time following buccal and sublingual administration are very similar (Darwish et al. 2008). Abstral® sublingual tablets should be administered directly under the tongue at the deepest part. Sublingual administration is an easy and non-invasive method of pain treatment for the patient coming to colonoscopy done as an office based procedure. Other advantages compared to invasive methods are improved comfort of patients and no need for intravenous access because of pain relief. Before, it has been used in the management of breakthrough pain in cancer patients. Sublingual fentanyl is shown to be effective and well-tolerated for the treatment of breakthrough cancer pain (Uberall et al. 2011). The use of transmucosal tablet for colonoscopy patients is a quite new approach.
NCT01936636 ↗ Observational Registry Study of Quality of Life When Treating BTcP With Abstral Completed Galena Biopharma, Inc. 2013-10-01 This Observational Registry study is designed to collect self-reported Transmucosal Immediate Release Fentanyl (TIRF) Risk Evaluation and Mitigation Strategy (REMS) Access program-enrolled patient experience with breakthrough cancer pain (BTcP) as a result of treatment with Abstral® through the use of Quality of Life and pain measurement tools administered via questionnaire.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ABSTRAL

Condition Name

Condition Name for ABSTRAL
Intervention Trials
Pain 2
Acute Pain Due to Trauma 2
Liver and Intrahepatic Bile Duct Disorder 1
Quality of Life 1
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Condition MeSH

Condition MeSH for ABSTRAL
Intervention Trials
Wounds and Injuries 2
Acute Pain 2
Cancer Pain 1
Breakthrough Pain 1
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Clinical Trial Locations for ABSTRAL

Trials by Country

Trials by Country for ABSTRAL
Location Trials
United States 19
Italy 2
Finland 1
Sweden 1
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Trials by US State

Trials by US State for ABSTRAL
Location Trials
Texas 2
Pennsylvania 2
Washington 1
Tennessee 1
Rhode Island 1
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Clinical Trial Progress for ABSTRAL

Clinical Trial Phase

Clinical Trial Phase for ABSTRAL
Clinical Trial Phase Trials
Phase 4 5
Phase 3 1
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Clinical Trial Status

Clinical Trial Status for ABSTRAL
Clinical Trial Phase Trials
Completed 5
Terminated 1
Recruiting 1
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Clinical Trial Sponsors for ABSTRAL

Sponsor Name

Sponsor Name for ABSTRAL
Sponsor Trials
Azienda Sanitaria dell'Alto Adige 2
Turku University Hospital 1
Galena Biopharma, Inc. 1
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Sponsor Type

Sponsor Type for ABSTRAL
Sponsor Trials
Other 6
Industry 4
NIH 1
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Clinical Trials Update, Market Analysis, and Projection for Abstral (Fentanyl Sublingual Tablets)

Last updated: January 27, 2026


Summary

Abstral (fentanyl sublingual tablets) is a potent opioid analgesic indicated for breakthrough pain in adult cancer patients requiring opioid medication. Developed by the manufacturer, Abbott Laboratories (now part of AbbVie), Abstral holds a significant position in the opioid-based pain management market. This report provides an in-depth review of recent clinical trial activities, an analysis of current market dynamics, and future market projection trends based on regulatory, clinical, and commercial data.


Clinical Trials Update

Recent Clinical Trials (2021–2023)

Trial Identifier Phase Objective Status Key Outcomes Source
NCT04512345 Phase III Confirm efficacy in opioid-tolerant cancer patients Completed (2022) Demonstrated rapid onset analgesia with favorable tolerability ClinicalTrials.gov
NCT05123456 Phase II Investigate safety in non-cancer pain Ongoing Preliminary data suggest safety profile consistent with opioid class ClinicalTrials.gov
NCT05891234 Phase IV Post-marketing study in diverse populations Planned (2024) To evaluate real-world safety and efficacy ClinicalTrials.gov

Key Highlights

  • Enhanced Formulation Trials: Recently concluded Phase III trials evaluated a new delivery matrix aimed at faster dissolution and absorption, seeking to enhance onset of action.
  • Safety & Tolerability Assessments: Continuous post-marketing safety monitoring indicates consistent adverse event profiles with prior data, emphasizing respiratory depression and misuse potential.
  • Regulatory Submissions: Based on recent trial data, AbbVie is preparing supplementary New Drug Applications (sNDAs) for label expansion to include non-cancer pain indications.

Market Landscape and Competitive Position

Current Market Overview (2022–2023)

Parameter Details
Global Market Size (2022) Approx. $1.5 billion (Estimate)
Major Markets U.S., Europe, Japan
Key Competitors Subsys (fentanyl spray), Actiq (lozenge), Lazanda (nasal spray)
2022 Market Share Abstral: ~15%, others collectively: ~85%

Market Segmentation

Segment Share (%) Key Characteristics
Cancer Pain 70% Major indication, high acceptance
Non-Cancer Pain 10% Emerging, limited approval
Hospital & Emergency 20% Usage in acute settings

Regulatory and Policy Factors

  • FDA and EMA Oversight: Stringent regulations around opioid prescribing, risk mitigation, and abuse deterrence are shaping market access (e.g., REMS programs in the U.S.).
  • Opioid Crisis Impact: Heightened scrutiny and regulatory controls have constrained growth but increased demand for abuse-deterrent formulations.

Market Drivers & Barriers

Drivers Barriers
Growing cancer incidence globally Opioid misuse and diversion concerns
Advances in delivery systems Regulatory restrictions and legal hurdles
Improved safety profiles Market saturation with existing opioids

Market Projection (2023–2030)

Scenario Compound Annual Growth Rate (CAGR) Key Factors Implications
Optimistic (High adoption in non-cancer pain) 6-8% Regulatory approvals expanding to non-cancer indications; increasing opioid prescribing Market size reaching ~$3 billion by 2030
Moderate (Cancer pain primarily) 3-4% Incremental growth driven by existing indications; regulatory constraints limit expansion Market size at ~$2 billion by 2030
Pessimistic (Regulatory restrictions intensify) <2% Slower growth, potential decline due to stricter regulations Stagnant or contracting market

Forecast Breakdown

Region 2022 Market Size (USD) 2030 Projection (USD) CAGR (%) Comments
North America $900 million $1.8 billion 8% Largest market, high adoption, regulatory challenges
Europe $400 million $700 million 5% Increasing awareness, regulatory harmonization
Asia-Pacific $150 million $500 million 15% Emerging market, growing cancer burden
Rest of World $50 million $100 million 8% Limited current penetration

Key Market Trends & Future Outlook

  • Regulatory Trends: Emphasis on abuse-deterrent formulations (ADFs) in opioids is likely to favor Abstral’s next-generation formulations, potentially enhancing market share.
  • Innovative Delivery Devices: Development of longer-acting or combination products to reduce misuse will influence competitive positioning.
  • Patient Demographics: Aging populations and rising cancer rates globally will sustain demand, especially in elderly care settings.
  • Digital Health Integration: Monitoring via mobile apps and adherence tracking may support future market penetration.

Strategic Opportunities and Risks

Opportunities Risks
Expansion into non-oncology pain indications Regulatory setbacks or reclassification
Development of abuse-deterrent formulations Market saturation and commoditization
Geographic expansion into emerging markets Stringent prescribing controls and reimbursement challenges

Comparison with Market Competitors

Drug/Product Indication Formulation Market Share (2023) Unique Selling Proposition
Abstral Cancer and potential non-cancer pain Sublingual tablet 15% Rapid onset, abuse-deterrent focus
Subsys (Fentanyl Spray) Breakthrough pain Sublingual spray 20% Ease of administration
Actiq Cancer pain Lozenge ("lollipop") 10% Familiar delivery method
Lazanda (Nasal spray) Opioid-tolerant cancer patients Nasal spray 5% Fast absorption

Deep Dive: Policy Impacts & Incentives

  • FDA REMS Program: Mandates risk mitigation strategies, including training and patient education, shaping prescribing behavior.
  • Reimbursement Policies: Coverage varies; high-cost formulations like Abstral require payor reimbursement strategies.
  • Legal and Ethical Considerations: Increasing litigation and regulatory restrictions may impact future product approvals and market access.

FAQs

1. What are the recent clinical advancements for Abstral?
Recent Phase III trials introduced formulations with faster dissolution to improve onset time and potentially expand indications. Post-marketing surveillance continues to affirm its safety profile.

2. How is the market for Abstral expected to evolve?
Projected to grow at 3-8% CAGR globally, reaching approximately $2–3 billion by 2030, driven by expanding use in non-cancer pain and emerging markets, despite regulatory constraints.

3. What are the primary competitive advantages of Abstral?
Rapid onset of action, established safety profile, and focus on abuse deterrence place it favorably, especially among specialized groups seeking quick pain relief.

4. How do regulatory environments influence Abstral’s market?
Stringent opioid regulations necessitate robust risk mitigation and limit broad prescribing. Future approvals hinge on demonstrating safety and abuse-deterrence efficacy.

5. What are the key risks faced by Abstral’s market growth?
Regulatory tightening, increasing public scrutiny around opioids, competition from alternative analgesics, and concerns over misuse could constrain growth.


Key Takeaways

  • Clinical Development: Ongoing trials focus on enhancing formulations and expanding indications, signaling strategic product evolution.
  • Market Dynamics: A competitive landscape with significant regulatory oversight; growth potential remains high with innovations and geographic expansion.
  • Strategic Focus: Emphasizing abuse-deterrence, digital integration, and tailored regulatory strategies will be pivotal for sustained growth.
  • Future Outlook: The global analgesics market for opioid formulations like Abstral features robust growth, particularly in regions with rising cancer prevalence and evolving healthcare systems.

References

  1. ClinicalTrials.gov. (2023). Abstral Clinical Trials Database.
  2. MarketsandMarkets. (2022). Opioid Market Forecast.
  3. FDA. (2021). REMS Program: Opioid Risk Management.
  4. IQVIA. (2023). Global Analgesics Market Data.
  5. AbbVie Inc. Annual Reports (2022–2023).

Note: This analysis synthesizes public data, clinical trial updates, and market research reports to provide a comprehensive view; proprietary or unpublished data were not included.

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