Efficacy and safety of sustained-release oxycodone compared with immediate-release morphine for pain titration in cancer patients

Abstract

Background: The study aims to investigate the effect and safety of sustained-release oxycodone hydrochloride as background dose on pain titration in patients with moderate-to-severe cancer pain. Material and methods: Adult patients scheduled with a regular strong opioid for cancer-related pain were recruited and randomly assigned to sustained-release oxycodone group (tablets, 12 hourly) and immediate-release morphine group (5 mg initially, hourly). All patients were hourly reassessed for efficacy and dose titration. Results: The primary end point was the number of titration cycles required to achieve adequate pain relief (numerical rating scale, NRS ≤ 3). Secondary end points included the proportion of patients achieving adequate pain relief during each cycle, potential predictive factors for titration performance, and side effects. Ninety (94.7%) patients in oxycodone group and 78 (86.7%) patients in morphine group achieved adequate pain control during 1 to 4 cycles of titration. Patients in oxycodone group reached adequate pain control within the first 2 cycles of titration, which was significantly shorter than morphine group wherein the number of titration cycles ranged from 1 to 4 ( P = .034). Oxycodone prescription significantly increased the response rate of patients to morphine titration during the first cycle of titration ( P = .010). The initial NRS score and oxycodone administration were significantly associated with titration performance. The mild or moderate adverse effects were similar in 2 groups, while severe adverse effects were only identified in morphine group ( P = .001). Conclusion: Use of background sustained-release oxycodone is more efficient and better tolerated on dose titration than immediate-release morphine.

The combined analgesic effect of pregabalin and morphine in the treatment of pancreatic cancer pain, a retrospective study

“…Addition of pregabalin resulted similar analgesic effect with 36% reduction of morphine dose in patients with pancreatic cancer pain. The dose change usually starts from 25% to 50% of the baseline when titrating the dose of morphine, [25][26][27] thus, the 36% reduction of morphine dose is considered significant for clinical practice.…”

Efficacy and Safety Aiming at the Combined-Modality Therapy of External Beam Radiotherapy (40Gy) and Iodine-125 Seed Implantation for Locally Advanced NSCLC in the Elderly

“…About 60–90% of patients with advanced cancer suffer from cancer-related pain, and this is a very common clinical issue. 20 , 33 At the same time, the cancer-related symptoms also greatly affect the patients, including dry cough, hoarseness and hemoptysis. Therefore, how to relieve cancer-related pain and ameliorate cancer-related symptoms to improve QOL is a critical question for doctors and patients.…”

Efficacy and Safety Aiming at the Combined-Modality Therapy of External Beam Radiotherapy (40Gy) and Iodine-125 Seed Implantation for Locally Advanced NSCLC in the Elderly

“…About 60-90% patients of advanced cancer will suffer from cancer-related pain throughout the process which is a very common clinical issue (20,33). At the same time, the cancer-related symptoms also bother patients, such as dry cough, hoarseness and hemoptysis.…”