Factors Affecting Opioid Treatment in Cancer Patients

Symeonidi, Matina; Panagiotou, Irene; Tsilika, Eleni; Roumeliotou, Anna; Galanos, Antonis; Mystakidou, Kyriaki

doi:10.18433/jpps29396

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…Common adverse events of morphine, including nausea, vomiting, constipation, and delirium, at baseline and within 24 and 72 h after starting morphine were retrospectively evaluated by two independent investigators from the descriptions of medical charts. Common adverse events were graded according to the Common Terminology Criteria for Adverse Events (version 4), and those with grade !3 were considered to be unacceptable common adverse events [14,15]. Laboratory data at the time of morphine administration and within 24 and 72 h after starting morphine were obtained.…”

Section: Definition and Measurementsmentioning

confidence: 99%

Experience of morphine therapy for refractory dyspnea as palliative care in advanced heart failure patients

Kawaguchi

Hamatani

Hirayama

et al. 2020

Journal of Cardiology

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Background: In the field of palliative care, morphine is known to be effective for alleviating dyspnea in cancer patients. However, little is known regarding the safety and efficacy of morphine therapy for refractory dyspnea as palliative care in advanced heart failure (HF) patients. Methods: We retrospectively reviewed consecutive advanced HF patients who were referred to the Palliative Care Team at our institution and administered morphine for refractory dyspnea during hospitalization between September 2013 and December 2018. We investigated the details of morphine usage, vital signs, an 11-point quantitative symptom scale, and adverse events at baseline, 24 h, and 72 h after the start of treatment. Results: Morphine was administered for refractory dyspnea in 43 advanced HF patients [mean age: 73.5 years, male: 28 (65%), New York Heart Association functional class IV: 43 (100%), median left ventricular ejection fraction: 25%, median B-type natriuretic peptide level: 927 pg/ml, concurrent intravenous inotrope: 33 (77%)]. Median initial dose of morphine was 5 mg/day in both oral and intravenous administration and median duration of administration was 5 days. Significant decreases in an 11-point quantitative symptom scale [7 (5, 9) vs. 2 (1, 6); p < 0.01, (data available in 8 patients)] and respiratory rate (22.2 AE 6.1 vs. 19.7 AE 5.2 breaths per minute; p < 0.01) were observed 24 h after the start of morphine administration. Meanwhile, oxygen saturation, blood pressure, and heart rate were not significantly altered after treatment (NS). Common adverse events were delirium (18%) and constipation (8%); however, no lethal adverse event definitely related to morphine therapy occurred during treatment. Conclusions: This single-center retrospective study revealed the clinical practice of morphine therapy and suggested that morphine therapy might be feasible for refractory dyspnea as palliative care in advanced HF patients.

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Section: Definition and Measurementsmentioning

confidence: 99%

Experience of morphine therapy for refractory dyspnea as palliative care in advanced heart failure patients

Kawaguchi

Hamatani

Hirayama

et al. 2020

Journal of Cardiology

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Clinical relevance of immune checkpoint inhibitors for the analgesic effect of opioids: A retrospective propensity score analysis

Sumimoto,

Tanaka,

Murakami

et al. 2024

Brit J Clinical Pharma

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AimsThis study aimed to determine the clinical relevance of the influence of coadministration of immune checkpoint inhibitors (ICIs) on the analgesic effects of opioids, focusing on the amount of change in opioid dosage.MethodsThis study used data from patients who used opioids during anticancer therapy at the Oita University Hospital between September 2014 and October 2023. The primary outcome measure was the amount of change in morphine mg equivalent opioid dose during the period of anticancer therapy. Propensity score matching was performed to reduce confounding effects.ResultsThe study enrolled 235 patients; 101 received ICI and 134 received no ICI. Before propensity score matching, there were significant differences between the ICI and non‐ICI groups in lines of anticancer therapy, type of primary cancer, body mass index, maximum opioid dose and the amount of change in opioid dose. Following propensity score matching, 73 patients each were included in the ICI and non‐ICI groups. Analysis of the propensity score‐matched cohort showed a significant increase in the median amount of change in opioid dose in ICI group vs non‐ICI group (22.5 vs. 15.0 morphine mg equivalents, interquartile range; 0.0, 40.0 vs. 0.0, 30.0, P = .044). Multiple regression analysis identified ICI administration and body mass index as significant independent factors associated with the amount of change in opioid dose (P = .014 and .027, respectively).ConclusionsICI administration significantly increased opioid dosage regardless of patient background. Our findings would provide valuable insight into future pain management strategies.

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Factors Affecting Opioid Treatment in Cancer Patients

Cited by 2 publications

References 40 publications

Experience of morphine therapy for refractory dyspnea as palliative care in advanced heart failure patients

Experience of morphine therapy for refractory dyspnea as palliative care in advanced heart failure patients

Clinical relevance of immune checkpoint inhibitors for the analgesic effect of opioids: A retrospective propensity score analysis

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