Use of OROS® hydromorphone in the treatment of osteoarthritis and osteoporosis: A pooled analysis of three non-interventional studies focusing on different starting doses

Abstract

A lower starting dose was associated with better tolerability and a lower number of treatment terminations at a comparable level of pain control with high treatment satisfaction.

End‐of‐Dose Pain in Chronic Pain: Does it Vary with the Use of Different Long‐Acting Opioids?

“…Two studies examined BTP frequency; both reported a decrease in BTP frequency with hydromorphone. Ten studies on hydromorphone reported results on the BTP medication frequency; 4 of these showed frequency was decreased from baseline, 1 showed an increase in BTP medication frequency from baseline, and 4 reported no difference in BTP medication frequency either from baseline or between hydromorphone and the comparator (either placebo or another opioid) …”

“…Ten studies on hydromorphone reported results on the BTP medication frequency; 4 of these showed frequency was decreased from baseline, 1 showed an increase in BTP medication frequency from baseline, and 4 reported no difference in BTP medication frequency either from baseline or between hydromorphone and the comparator (either placebo or another opioid). [24][25][26][27][28][29][30][31][32][33] The single study that looked at end-of-dose pain examined OROS â hydromorphone and found decreases from baseline (which consisted of use of IR oxycodone) for all the target outcomes. 27 Morphine.…”

A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid‐Naive Cancer Patients: Results of the Korean South West Oncology Group Study

“…To follow this general guideline, it takes >1 week to achieve proper pain control when converting to long-acting opioids from short-acting or immediate-releasing opioids. Ringe et al ( 7 ) compared a lower starting dose (4 mg/day) of OROS hydromorphone to a higher starting dose (8 mg/day) in terms of tolerability, pain control and treatment satisfaction overall for subgroups of opioid-naive patients versus patients previously treated with opioids. This study was a post hoc analysis that included three different studies that used two different starting doses.…”

“…However, there are very limited data demonstrating the efficacy and safety of OROS hydromorphone in cancer patients without previous exposure to a strong opioid analgesic. Recently in Europe, efficacy and safety were compared between starting doses of 4 mg and 8 mg; the lower dose (4 mg) demonstrated better tolerability and a lower number of treatment terminations at a comparable level of pain control with high treatment satisfaction ( 7 ). However, this study was also limited to patients with severe, chronic, noncancer pain associated with osteoarthritis and osteoporosis.…”

“…The objective of the present study was to evaluate the efficacy and tolerability of OROS hydromorphone in opioid-naive cancer patients experiencing moderate to severe cancer pain. In the present study, 4 mg of OROS hydromorphone was used as a starting dose, which is the recommended amount for noncancer patients in the literature ( 7 ). The outcome of the present study will provide meaningful information on the clinical benefit of OROS hydromorphone as an upfront therapy in opioid-naive cancer patients.…”