Efficacy of immediate-release oxycodone for dyspnoea in cancer patient: cancer dyspnoea relief (CDR) trial.

Abstract

BACKGROUND:

Guidelines recommend morphine as the first-line pharmacological treatment for cancer dyspnoea. However, trials with other opioids have not been performed. Our aim was to demonstrate the non-inferiority of oxycodone to morphine for relieving dyspnoea in cancer patients.

METHODS:

We conducted a multicentre, open-label, parallel-group, randomized control trial. We randomly and equally assigned cancer patients on regular oxycodone who developed dyspnoea to get a single dose of oral immediate-release oxycodone or morphine. We evaluated the change in dyspnoea intensity (numeric rating scale: 0-10) and adverse events after the medication administration.

RESULTS:

This study was preconfidence interval -maturely terminated. All 17 enroled patients (8 using oxycodone, 9 using morphine) completed evaluations. In the oxycodone group, dyspnoea intensity decreased 1.75 points [95% confidence interval, 0.72-2.78] at 60 min and 1.50 points (95% confidence interval, -0.11 to 3.11) at 120 min. In the morphine group, dyspnoea decreased 1.33 points (95% confidence interval, 0.41-2.25) at 60 min and 1.00 point (95% confidence interval, -0.08 to 2.08) at 120 min. The differences did not fulfil the non-inferiority requirement. Although two and four patients in morphine group developed drowsiness at 60 and 120 min, no patient in oxycodone group developed significant adverse events.

CONCLUSIONS:

Although we did not show the non-inferiority of oxycodone, oxycodone may have some effectiveness for cancer dyspnoea without significant safety concern.

CLINICAL TRIAL REGISTRATION:

UMIN-CTR: UMIN 000005760.

• Authors: Takashi Yamaguchi, Yoshinobu Matsuda, Hiromichi Matsuoka, Takayuki Hisanaga, Iwao Osaka, Hiroaki Watanabe, Isseki Maeda, Kengo Imai, Satoru Tsuneto, Yukiko Wagatsuma, Yoshiyuki Kizawa
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 48 Issue 12 Pg. 1070-1075 (Dec 01 2018) ISSN: 1465-3621 [Electronic] England
• PMID: 30260399 (Publication Type: Journal Article)

Chemical References

• Analgesics, Opioid
• Oxycodone

Topics

• Adult
• Aged
• Analgesics, Opioid (pharmacology, therapeutic use)
• Dyspnea (drug therapy)
• Female
• Humans
• Male
• Middle Aged
• Neoplasms (drug therapy)
• Oxycodone (pharmacology, therapeutic use)