Efficacy and tolerability of once-daily OROS® hydromorphone and twice-daily extended-release oxycodone in patients with chronic, moderate to severe osteoarthritis pain: Results of a 6-week, randomized, open-label, noninferiority analysis

Hale, M.; Tudor, Iulia Cristina; Khanna, Subhash K.; Thipphawong, John

doi:10.1016/j.clinthera.2007.05.016

Cited by 77 publications

(103 citation statements)

References 34 publications

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“…Th ree articles compared fentanyl and morphine (PICO #1); fi ve articles assessed hydromorphone (PICO #2), two of which analyzed the 1 + 1 hydromorphone protocol (PICO #3); three articles compared oral hydromorphone and oxycodone (PICO #4); eight articles compared non-specifi c NSAIDs and co deine-acetaminophen (PICO #5); two articles compared specifi c NSAIDs and co deine-acetaminophen (PICO #6); and fi ve articles compared oxycodone and codeine (PICO #7). Th e same reviewer assessed the full text articles and determined that 14 of the 26 off ered quantitative results that could be analyzed using the GRADE-pro software [28][29][30][31][32][33][34][35][36][37][38][39][40][41]. Th e remaining 12 articles were excluded because they did not compare both drugs assessed in a PICO question [42][43][44][45][46][47], compared analgesics not addressed in the seven P ICO qu estions (such as acetaminophen alone) [48,49], used unconventional medication dosing [50,51], used non-validated pain me asurement scales [52,53], and/or unusual study designs [50].…”

Section: Resultsmentioning

confidence: 99%

“…However, although the number of studies used to make our recommendations may seem low, our re commendations take into consideration the quality of evidence of the studies. Pragmatic derivations of the seven PICO questions, their recommendations, and the rationale for these recommendations are listed in Table 4 [28][29][30][31][32][33][34][35][36][37][38][39][40][41]. Furthermore, we also developed a fl owchart as a suggested approach to analges ia in the ED (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…We are unable to comment on the superiority/inferiority of either of these drugs in treating acute pain The only studies we identifi ed that compared these drugs assessed the extended release forms of hydromorphone (Exalgo®) and oxycodone Further research is needed to assess the immediate release forms of hydromorphone (e. g., Dilaudid®) and oxycodone, and whether they have a role in treating acute pain in the emergency department Rationale [34,35] • We only identifi ed two studies comparing hydromorphone and oxycodone.…”

Section: Should Hydromorphone or Oxycodone Be Used For Acute Pain?mentioning

confidence: 99%

See 2 more Smart Citations

Analgesia in the Emergency Department: A GRADE-based Evaluation of Research Evidence and Recommendations for Practice

Lipp

Dhaliwal

Lang

2013

Annual Update in Intensive Care and Emergency Medicine 2013

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Emergency physicians care for patients with pain on an extremely frequent basis [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Th e prevalence of pain as the presenting complaint of patients seeking eme rgen cy department (ED) care ranges from 38 % [3] to as high as 78 % [1]. As a result, evidence-based use of analgesics should be a foundational skill of emergency physicians. However, the literature consistently reports that emergency physicians are ofte n poor at treating pain [1,2,8,13,14,16,19,20] . Notwithstanding the prevalence of pain in the ED, many patients often report that their pain was no t pr oper ly t reated [3,7,20]. I n addi tion to a compromised patient experience, sub-optimal treatment of pain will result in decreased department fl ow, increased wait times, more return visits to the ED, and increased hospitalization rates.Very few evidence-based resources and guideli nes exis t to inform emergency physicians on how to treat pain. One recent guideline on acute pain management compiled by the college of Anaesthetists of Australia and New Zealand [21] was focused primarily on treating pain perioperatively and did not include stratifi ed or graded recommendations based on the literature, highlighting the paucity of emergency medicine-specifi c guidance. Emergency physicia ns need an eff ective, evidenced-based approach to analyze and apply the options available for acute pain management.Th e objective of this article is to synthesize and evaluate the quality of medical literature surrounding analgesia delivery in the adult ED using the Grading Assessment, Development and Evaluation (GRADE) framework. We further strived to provide emergency physicians with graded recommendations upon which analgesics should be used to treat adults with acute pain in the ED. Question formulationPrior to searching the literature we developed seven clinically-oriented questions based on a scoping of the literature and a review of locally utilized ED analgesic order sets. Th is initial surveying of medical literature and our local practice environment allowed us to identify the most commonly prescribed intravenous and oral analgesics used in adult EDs in our health care region.We then used the patient-intervention-comparisonoutcome (PICO) approach to develop our seven research questions (Table 1). Th is approach has been adopted by many authors of systematic reviews and guideline panels, including the Internati onal Liaison Committee on Resuscitation (ILCOR) and the American College of Chest Physicians (ACCP) [22][23][24]. It involves identifying a specifi c population or setting to which recommen dations may be applied. Subseq uently each question compares two specifi c management strategies (intervention and comparison). Fi nally, we defi ned important patient oriented outcomes (e. g., change in pain) as well as any adverse eff ects of the medication or other safety concerns.All seven draft questions were reviewed and revised through an iterative process involving all authors. Th ese seven cl...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Should Hydromorphone or Oxycodone Be Used For Acute Pain?mentioning

confidence: 99%

See 1 more Smart Citation

Analgesia in the Emergency Department: A GRADE-based Evaluation of Research Evidence and Recommendations for Practice

Lipp

Dhaliwal

Lang

2013

Annual Update in Intensive Care and Emergency Medicine 2013

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show abstract

“…Improvements in WOMAC scores have been observed in studies of fentanyl, oxycodone, oxycodone/acetaminophen, morphine sulfate, oxymorphone, and hydromorphone for osteoarthritis pain (Caldwell et al, 2002;Hale et al, 2007;Katz et al, 2010;Langford et al, 2006;Matsumoto et al, 2005). In addition, improvements in sleep, mood, and enjoyment of life have been associated with opioid analgesic therapy for the management of chronic osteoarthritis pain (Rosenthal et al, 2007;Roth et al, 2000).…”

Section: Opioidsmentioning

confidence: 98%

“…Opioid treatment has also been associated with significant improvements in physical function and quality of life (Avouac et al, 2007;Caldwell et al, 2002;Hale et al, 2007;Matsumoto et al, 2005;Nuesch et al, 2009;Rosenthal et al, 2007;Roth et al, 2000). Improvements in WOMAC scores have been observed in studies of fentanyl, oxycodone, oxycodone/acetaminophen, morphine sulfate, oxymorphone, and hydromorphone for osteoarthritis pain (Caldwell et al, 2002;Hale et al, 2007;Katz et al, 2010;Langford et al, 2006;Matsumoto et al, 2005).…”

Section: Opioidsmentioning

confidence: 99%

Long-Term Treatment of Osteoarthritis Pain: Achieving a Balance Between Efficacy and Tolerability for a Successful Chronic Therapy

Etropolski¹

2012

Osteoarthritis - Diagnosis, Treatment and Surgery

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Oral or transdermal opioids for osteoarthritis of the knee or hip

Nüesch

Rutjes²,

Husni

et al. 2009

Cochrane Database of Systematic Reviews

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BackgroundOsteoarthritis is the most common form of joint disease and the leading cause of pain and physical disability in the elderly. Opioids may be a viable treatment option if patients suffer from severe pain or if other analgesics are contraindicated. However, the evidence about their effectiveness and safety is contradictory. ObjectivesTo determine the effects on pain and function and the safety of oral or transdermal opioids as compared with placebo or no intervention in patients with osteoarthritis of the hip or knee.

show abstract

Efficacy and tolerability of once-daily OROS® hydromorphone and twice-daily extended-release oxycodone in patients with chronic, moderate to severe osteoarthritis pain: Results of a 6-week, randomized, open-label, noninferiority analysis

Cited by 77 publications

References 34 publications

Analgesia in the Emergency Department: A GRADE-based Evaluation of Research Evidence and Recommendations for Practice

Analgesia in the Emergency Department: A GRADE-based Evaluation of Research Evidence and Recommendations for Practice

Long-Term Treatment of Osteoarthritis Pain: Achieving a Balance Between Efficacy and Tolerability for a Successful Chronic Therapy

Oral or transdermal opioids for osteoarthritis of the knee or hip

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