Controlled-release morphine tablets in patients with chronic cancer pain

Warfield, Carol A.

doi:10.1002/(sici)1097-0142(19980615)82:12<2299::aid-cncr1>3.0.co;2-o

Cited by 22 publications

(11 citation statements)

References 24 publications

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“…Longer-duration morphine tablets have been available since the early 1980s and have become routine therapy for the management of cancer pain [10,11]. In a number of well-controlled clinical trials in cancer patients, CR morphine administered every 12 h (q12 h) provided uniformly effective analgesia at doses of 90-330 mg per day with a discontinuation rate of only 2% [10].…”

Section: Long-acting Morphinementioning

confidence: 99%

“…In a number of well-controlled clinical trials in cancer patients, CR morphine administered every 12 h (q12 h) provided uniformly effective analgesia at doses of 90-330 mg per day with a discontinuation rate of only 2% [10]. For example, a double-blind crossover study comparing CR morphine q12 h with IR morphine q4 h, each up-titrated as needed for pain relief, in 14 patients with chronic cancer pain found equal analgesic efficacy with both drugs.…”

Section: Long-acting Morphinementioning

confidence: 99%

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Advances in opioid therapy and formulations

Walsh

2004

Support Care Cancer

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Newly developed opioid analgesics and drug delivery systems may provide pain relief for patients intolerant of morphine. Long-acting oral opioids supply satisfactory analgesia at more convenient dosing intervals. Implantable pumps can provide full analgesic doses of opioids both subcutaneously and intrathecally over extended time periods. Optimal opioid use should rely on individualized dose-finding approaches to enhance pain relief while limiting drug-related side effects and avoiding the common problems associated with opioid prescription in clinical practice.

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Section: Long-acting Morphinementioning

confidence: 99%

Section: Long-acting Morphinementioning

confidence: 99%

Advances in opioid therapy and formulations

Walsh

2004

Support Care Cancer

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“…In addition, modified‐release opioids clearly have benefits that extend beyond compliance. Several studies have demonstrated that modified‐release opioids are effective and can be given safely in a variety of conditions, including cancer, back pain, diabetic neuropathy, laparoscopic surgery, arthritis, and other conditions 6–11 . Several studies also have suggested that modified‐release opioids may result in fewer side effects than observed with short‐acting opioids 12–14 .…”

Section: Introductionmentioning

confidence: 99%

A Study of AVINZA^® (Morphine Sulfate Extended‐Release Capsules) for Chronic Moderate‐to‐Severe Noncancer Pain Conducted Under Real‐World Treatment Conditions—The ACCPT Study

Adams

Chwiecko²,

Ace-Wagoner³

et al. 2006

Pain Practice

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This study evaluated the clinical effects and pattern of use of AVINZA((r)), morphine sulfate extended-release tablets, under real-world treatment conditions. Opioid-naive subjects or subjects who have failed other opioids were eligible if they had chronic moderate-to-severe noncancer pain with an average pain score > or =4 (0-10 scale) in the preceding month. Subjects answered in-depth monthly questionnaires in three months. For the 491 evaluable subjects enrolled, the median AVINZA dose was 30 mg at baseline, titrated to 60 mg by month 1, and remained at 60 mg through month 3. Adherence was high, with almost 90% of the subjects reporting never having forgotten to take AVINZA. Mean daily pain scores (scale 0-10) significantly improved from 7.83 at enrollment to 5.77 at month 1 (P < 0.01) and then remained at this level through month 3. Significant improvements were seen in all sleep measures, and the mean Composite Sleep Score, a global measure of sleep quality (scale 0-10), significantly improved from 5.73 at baseline to 4.96 at month 3 (P < 0.01). Physical functioning was improved for activities requiring a moderate effort (P = 0.053), such as climbing one flight of stairs (P = 0.008). Two hospitalizations for nausea and vomiting were the only reported drug-related serious adverse events. This study showed that once-daily AVINZA significantly reduced pain scores, and resulted in improved sleep and physical functioning in patients with chronic moderate-to-severe pain. These results were achieved with a stable daily morphine dose over the three-month study period.

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“…3,6,7,9 Oral controlled-release (CR) opioid formulations have proved effective in providing continuous analgesia for the chronic pain of cancer. [10][11][12][13][14] CR morphine formulations have been the mainstay in cancer pain management for more than a decade because they are easy to administer and to titrate. 9 The fentanyl transdermal system is an alternative long-acting opioid for use in patients with chronic malignant pain.…”

Section: Introductionmentioning

confidence: 99%

Transdermal fentanyl in the hospice: A survey of rescue dosing and pain control

Robards

2001

Am J Hosp Palliat Care

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The case records of 25 patients who received transdermal fentanyl as a primary analgesic during routine hospice care were surveyed for pain control and rescue medication use. The majority of patients (76 percent) had cancer-related pain and were treated in hospice for an average of approximately 30 days. Most received oral medications for supplemental rescue analgesia. During the sampling periods, on average, pain intensity was reported as mild. Over the same periods, patients required a mean of 6.1 (+/- 0.7) doses of rescue medication per day, with a range of zero to 12 doses per day. Five patients required rescue dosing every two hours on some treatment days. Although adequate pain control was generally accomplished with transdermal fentanyl in the group as a whole, the frequency of rescue dosing outside of the initial titration period appears unacceptably high.

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Controlled-release morphine tablets in patients with chronic cancer pain

Cited by 22 publications

References 24 publications

Advances in opioid therapy and formulations

Advances in opioid therapy and formulations

A Study of AVINZA^® (Morphine Sulfate Extended‐Release Capsules) for Chronic Moderate‐to‐Severe Noncancer Pain Conducted Under Real‐World Treatment Conditions—The ACCPT Study

Transdermal fentanyl in the hospice: A survey of rescue dosing and pain control

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Controlled-release morphine tablets in patients with chronic cancer pain

Cited by 22 publications

References 24 publications

Advances in opioid therapy and formulations

Advances in opioid therapy and formulations

A Study of AVINZA® (Morphine Sulfate Extended‐Release Capsules) for Chronic Moderate‐to‐Severe Noncancer Pain Conducted Under Real‐World Treatment Conditions—The ACCPT Study

Transdermal fentanyl in the hospice: A survey of rescue dosing and pain control

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A Study of AVINZA^® (Morphine Sulfate Extended‐Release Capsules) for Chronic Moderate‐to‐Severe Noncancer Pain Conducted Under Real‐World Treatment Conditions—The ACCPT Study