Objective: The aim of this study was to compare the therapeutic effects of immediate-release morphine (IR) and controlled-release oxycodone (CR) tablets on cancer pain in patients with an analgesia history of opioid or non-opioid analgesics by titration. Methods: This study was completed by six medical institutions, together, which adopted perspective and double-blind open-label methods to randomly divide cancer pain patients, from December 2014 to December 2017, into four groups: naive IR, naive CR, tolerant IR, and tolerant CR. Results: Kaplan-Meier analysis showed that remission of pain in the naive CR group (n = 58) was superior to that in the naive IR group (n = 47) (P = 0.031). Pain control in the tolerant CR group (n = 52) was superior to that in the tolerant IR group (n = 49) (P < 0.001). Differences were observed in titration cycles among the four groups (P < 0.001). There were differences in total titration doses among the four groups (P < 0.001). Consumption of oxycodone hydrochloride tablets in the naive CR group was lower than that that in the naive IR group (All P < 0.001) duringW1 & W2, whereas no significant differences were observed between the tolerant IR group and tolerant CR group during W1 (P = 0.061) & W2 (P = 0.060). The incidence rate of additional drug delivery in the naive CR group was less than that in the naive IR group (P = 0.007). There was a lower incidence rate of additional drug delivery in the tolerant CR group, compared with that in the tolerant IR group (P = 0.014). There were no significant differences in adverse effects among the four groups (All P > 0.05). Conclusion: As a therapeutic oral drug, controlled-release oxycodone may obtain more stable analgesic effects than immediate-release morphine, whether the patient has an analgesia history of opioid analgesics or not. Fewer doses are required during treatment, thus it should be used in clinic for cancer pain.
基金:
Wuxi Commission of Health and Family Planning, General Program of Nanjing Medical University [2016NJMU131, MS201639, Q20-1713, T201631]
第一作者单位:[1]Nanjing Med Univ, Wuxi Hosp 2, Dept Anesthesiol, Wuxi, Jiangsu, Peoples R China[6]Nanjing Univ, Sch Med, Dept Anesthesiol, Jinling Hosp, Nanjing 210000, Jiangsu, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Zhu Minmin,Liang Xiao,Gu Zhen,et al.Multicenter trial of titration of morphine versus oxycodone for cancer pain[J].INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE.2019,12(6):7317-7326.
APA:
Zhu, Minmin,Liang, Xiao,Gu, Zhen,Zhang, Li,Xie, Guangru...&Xu, Jianguo.(2019).Multicenter trial of titration of morphine versus oxycodone for cancer pain.INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE,12,(6)
MLA:
Zhu, Minmin,et al."Multicenter trial of titration of morphine versus oxycodone for cancer pain".INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE 12..6(2019):7317-7326