Treatment of chronic moderate-to-severe non-malignant pain with polymer-coated extended-release morphine sulfate capsules

Abstract

P-ERMS was efficacious and well tolerated in patients with chronic, moderate-to-severe, non-malignant pain when used once or twice daily.

Randomized trial comparing polymer-coated extended-release morphine sulfate to controlled-release oxycodone HCl in moderate to severe nonmalignant pain

“…In general, studies on kappa agonistsantagonists indicate greater analgesia in women than men 53 , but studies of sex differences in response to µ-agonists, such as morphine, have yielded conflicting results [53][54][55][56] , likely due to differences in clinical pain vs. experimental pain, modality and intensity of pain stimulus used, opioid type and dose, experimental design and data analytic techniques 53,55,57 . Previous studies specific to P-ERMS and CRO have demonstrated similar outcomes regardless of sex 19,21 .…”

“…The T max was longer than that with another QD morphine sulfate capsule 16 . The results of the KADIAN: Response Of Nonmalignant, Under-treated Subjects with Moderate/Severe Pain (KRONUS-MSP) trial show that P-ERMS is well tolerated and associated with significant improvement in pain, sleep and quality-of-life measures in patients with chronic, moderate to severe, nonmalignant pain 19 . A retrospective study of long-term use of P-ERMS in patients with chronic, nonmalignant pain indicated that these patients could maintain efficacy without escalation in dose strength or frequency 20 .…”

Pain Management with Opioid Analgesics

“…One study randomized patients with chronic pain who were not adequately relieved with their current therapy to an extended-release morphine preparation. 149 Improvements were reported in pain and sleep scores, physical and mental component scores of the SF-36v2 Health Survey, and patient and clinician global assessment scores. 149 Instructions for the conversions to a long-acting opioid from a short-acting agent are usually found in the Prescribing Information for individual drugs.…”

KADIAN® (morphine sulfate extended-release) Capsules for treatment of chronic, moderate-to-severe, nonmalignant pain

“…In the KRONUS‐MSP (KADIAN ® : Response Of Non‐malignant, Under‐treated Subjects with Moderate/Severe Pain) trial, the efficacy and tolerability of KADIAN ® were evaluated for the treatment of chronic, moderate‐to‐severe, nonmalignant pain [visual numeric scale (VNS) pain score ≥ 4] in 1428 patients who had been inadequately treated with other opioids. In this large, prospective trial, patients were randomised to receive KADIAN ® q24 h in the morning or evening for a 4‐week period (33). Treatment was initiated q24 h, with dose increases allowed after week 1 or 2.…”

“…Quality‐of‐life and clinician global assessments were analysed at baseline and week 4. Additional follow‐up, to determine continued usage and global assessment of therapy, was requested 1 month after trial completion and obtained via a business reply card (BRC) (33). Improvements in Pain VNS score, Sleep VNS score, SF‐36v2™ score (34) and Patient and Clinician Global Assessment of Therapy scores were used to measure efficacy outcomes (33).…”