Efficacy and Safety of Controlled-Release Versus Immediate-Release Oxycodone: Randomized, Double-Blind Evaluation in Patients with Chronic Back Pain

Hale, M.; Fleischmann, Roy; Salzman, Robert T.; Wild, James; Iwan, T.; Swanton, Ruth; Kaiko, Robert F.; Lacouture, Peter G.

doi:10.1097/00002508-199909000-00004

Cited by 126 publications

(98 citation statements)

References 8 publications

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“…Therefore, little evidence shows that either SAOs or LAOs are superior for the treatment of CNCP. [48][49][50][51] OSTEOARTHRITIS Osteoarthritis, the most common rheumatologic disorder and a primary cause of disability, is associated with structural malfunction of the synovial joints. 52 Osteoarthritis affects approximately half the population 65 years and older and currently affects 1 in 5 Americans overall.…”

Section: Analgesic Efficacy Of Laos and Saos In Common Cncp Conditionsmentioning

confidence: 99%

“…Treatment with IR oxycodone resulted in significantly improved pain scores in trials lasting up to 4 weeks. 49,66 In a study comparing CR oxycodone twice daily with IR oxycodone 4 times daily, both treatments, at equivalent daily doses, provided comparable reductions in pain intensity for patients with moderate to severe LBP. 49 Given that certain SAOs and LAOs have been reported to provide substantial analgesia in patients with chronic LBP, it is important to analyze available data to determine whether one of these groups of medications is superior to the other.…”

Section: Low Back Painmentioning

confidence: 99%

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A Comparison of Long- and Short-Acting Opioids for the Treatment of Chronic Noncancer Pain: Tailoring Therapy to Meet Patient Needs

Argoff

Silvershein

2009

Mayo Clinic Proceedings

115

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Management of chronic noncancer pain (CNCP) requires a comprehensive assessment of the patient, the institution of a structured treatment regimen, an ongoing reassessment of the painful condition and its response to therapy, and a continual appraisal of the patient's adherence to treatment. For many patients with CNCP, the analgesic regimen will include opioids. Physicians should consider the available evidence of efficacy, the routes of administration, and the pharmacokinetics and pharmacodynamics of the various formulations as they relate to the temporal characteristics of the patient's pain. When making initial decisions, physicians should decide whether to prescribe a shortacting opioid (SAO) with a relatively quick onset of action and short duration of analgesic activity, a long-acting opioid (LAO) with a longer duration of analgesic action but a potentially longer onset of action, or both. Studies suggest that SAOs and LAOs are both effective for most types of CNCP. A review of published studies found no data to suggest that either SAOs or LAOs are generally more efficacious for treating any particular CNCP condition. The LAOs may provide more stable analgesia with less frequent dosing; however, opioid therapy should be tailored to the pain state and the individual patient, and SAOs may be appropriate for some patients with CNCP. MEDLINE and PubMed searches were conducted to locate relevant studies published from January 1975 to April 2008 using the following search terms: opioids, short-acting opioids, long-acting opioids, chronic pain, chronic pain AND opioids, and narcotics. English-only randomized controlled trials and nonrandomized studies were considered.Mayo Clin Proc. 2009;84(7):602-612 ADL = activities of daily living; AE = adverse effect; ATC = around-theclock; BPI = Brief Pain Inventory; CNCP = chronic noncancer pain; CR = controlled-release; DN = diabetic neuropathy; ER = extended-release; IR = immediate-release; LAO = long-acting opioid; LBP = low back pain; NSAID = nonsteroidal anti-inflammatory drug; PHN = postherpetic neuralgia; QOL = quality of life; SAO = short-acting opioid; SNRI = serotonin norepinephrine reuptake inhibitor; SR = sustained-release; TCA = tricyclic antidepressant

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Section: Analgesic Efficacy Of Laos and Saos In Common Cncp Conditionsmentioning

confidence: 99%

Section: Low Back Painmentioning

confidence: 99%

A Comparison of Long- and Short-Acting Opioids for the Treatment of Chronic Noncancer Pain: Tailoring Therapy to Meet Patient Needs

Argoff

Silvershein

2009

Mayo Clinic Proceedings

115

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“…Since the end of 1998, an additional six placebo controlled trials have been published, providing further evidence for the effectiveness of opioid therapy in improving the quality of life of patients with musculoskeletal arthritic and neuropathic pain (14)(15)(16)(17)(18)(19). None of these trials has studied large numbers of patients, nor have the patients been studied for longer than six months, but this is no different from the existing situation with studies of opioid use in cancer pain.…”

Section: The Evolving Evidence For Opioid Therapymentioning

confidence: 99%

Use of Opioid Analgesics for the Treatment of Chronic Noncancer Pain ‐ A Consensus Statement and Guidelines from the Canadian Pain Society, 2002

Jovey

Ennis

Gardner-Nix

et al. 2003

Pain Research and Management

123

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“…However, at present, there is little evidence to support the use of one strong opioid over another in the treatment of cancer-related pain. Drug company trials have focused on acute and/or nonmalignant pain [12,13], such as chronic back pain, and care should be taken when extrapolating data from those trials to support use in patients with cancer who, by nature, are less well and often taking multiple concomitant medications. To date, large RCTs have not been undertaken to directly compare opioids for cancer-related pain, and smaller individual trials are underpowered to demonstrate superiority of one opioid over another [14][15][16][17][18][19].…”

Section: Evidence-based Rationale For Switching: Clinical Trialsmentioning

confidence: 99%

Clinical Pharmacology and Pharmacotherapy of Opioid Switching in Cancer Patients

Ross¹,

Riley²,

Quigley³

et al. 2006

The Oncologist

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Pain is one of the most common and often most feared symptoms in patients with cancer. Ongoing or progressive pain is physically debilitating and has a marked impact on quality of life. Since a third of the population will die from cancer, and of these, 80% will experience severe pain in their final year of life, effective treatment of cancer-related pain remains both a high priority and an ongoing challenge in clinical practice. Individuals with moderate to severe cancer-related pain require treatment with strong analgesics, namely opioids.There is evidence to support the therapeutic maneuver of opioid switching in clinical practice, but further evidence is needed to elucidate the underlying mechanisms for interindividual differences in response to different opioids. Large, robust clinical trials will be needed if clinical differences among side-effect profiles of different opioids are to be clearly demonstrated. This review discusses candidate genes, which contribute to opioid response; many other genes have also been implicated in "pain" from animal or human studies. In order to continue to evaluate the genetic contributions to both pain susceptibility and analgesic response, further candidate genes need to be considered. Good pain control remains a high priority for clinicians and patients, and there is much work to be done to further individualize analgesic therapy for patients with cancer.

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Efficacy and Safety of Controlled-Release Versus Immediate-Release Oxycodone: Randomized, Double-Blind Evaluation in Patients with Chronic Back Pain

Cited by 126 publications

References 8 publications

A Comparison of Long- and Short-Acting Opioids for the Treatment of Chronic Noncancer Pain: Tailoring Therapy to Meet Patient Needs

A Comparison of Long- and Short-Acting Opioids for the Treatment of Chronic Noncancer Pain: Tailoring Therapy to Meet Patient Needs

Use of Opioid Analgesics for the Treatment of Chronic Noncancer Pain ‐ A Consensus Statement and Guidelines from the Canadian Pain Society, 2002

Clinical Pharmacology and Pharmacotherapy of Opioid Switching in Cancer Patients

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