Rapid titration with oral sustained-release morphine plus subcutaneous morphine in a multi-center, randomized control study of cancer patients with moderate to severe cancer pain

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BACKGROUND: Pain is one of the most common concomitant symptoms among cancer patients. Pharmacologic agents are regarded as a cornerstone of cancer pain management. 'Dose titration' with short-acting morphine is widely accepted. Such a titration method is very complicated. The analgesic background establishment is often delayed. Titration based on sustained-release opioids is also recommended, but the onset of analgesic effect requires hours, whereas the rescue analgesia is always needed. This study evaluated the optimized morphine titration scheme with a simultaneous combination of sustained-release morphine and subcutaneous morphine.

METHODS: In a multicenter, 7-day, randomized controlled study, patients with moderate to severe cancer pain were assigned to receive either sustained-release morphine and subcutaneous morphine simultaneously (rapid titration) or only subcutaneous morphine to dose titration. The primary outcome was the safety and the number of times of rescue therapy as needed in the first 24 h.

RESULTS: A total of 108 patients with moderate to severe cancer pain were included in the study. The number of times of rescue analgesics in the first 24 h significantly reduced in the rapid titration group (0.4 ± 0.48 vs. 2.3 ± 0.78, P = 0.000). No differences in the intensity of opioid-related symptoms were found between the two groups.

CONCLUSIONS: Rapid titration is safe and efficient, which could significantly decrease rescue analgesics in the first 24 h and achieve better analgesic efficacy for cancer pain patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:52

Enthalten in:

Japanese journal of clinical oncology - 52(2022), 11 vom: 03. Nov., Seite 1303-1310

Sprache:

Englisch

Beteiligte Personen:

Sun, Yu [VerfasserIn]
Wei, Hao [VerfasserIn]
Yu, Min [VerfasserIn]
Zheng, Rujun [VerfasserIn]
Li, Junying [VerfasserIn]
Fu, Yan [VerfasserIn]
Zheng, Yuzhu [VerfasserIn]
Zhang, Xi [VerfasserIn]
Shou, Feng [VerfasserIn]
Zhou, Jin [VerfasserIn]
Yao, Wenxiu [VerfasserIn]
Chen, Ping [VerfasserIn]
Liu, Dingyi [VerfasserIn]
Jia, Yuming [VerfasserIn]
Fu, Yu [VerfasserIn]
Wang, Yan [VerfasserIn]
Zhu, Jiang [VerfasserIn]

Links:

Volltext

Themen:

76I7G6D29C
Analgesics, Opioid
Cancer pain
Delayed-Action Preparations
Journal Article
Morphine
Multicenter Study
Opioids
Randomized Controlled Trial
Rapid titration
Short-acting morphine
Sustained-release morphine

Anmerkungen:

Date Completed 04.11.2022

Date Revised 04.11.2022

published: Print

Citation Status MEDLINE

doi:

10.1093/jjco/hyac128

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM34465706X