Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2004
Addition of a second opioid may improve opioid response in cancer pain: preliminary data.
Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 67 citations in OpenAlex.
- The role of methadone in opioid rotation-a Polish experience.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2009Trial
- Opioid Add-On Combination Therapy for Cancer Pain: Pharmacological Rationale, Clinical Evidence, and Future Directions.CNS drugs · 2026Review
- Opioid therapy trajectories of patients with chronic non-cancer pain over 1 year of follow-up after initiation of short-acting opioid formulations.Pain medicine (Malden, Mass.) · 2024Article
- The Use of Low-Dose Methadone as Add-On to Ongoing Opioid Treatment in Palliative Cancer Care-An Underrated Treatment?Life (Basel, Switzerland) · 2022Review
- Methadone as First-line Opioid for the Management of Cancer Pain.The oncologist · 2022Article
- Continuous subcutaneous infusion for pain control in dying patients: experiences from a tertiary palliative care center.BMC palliative care · 2020Observational
- Lack of Antinociceptive Cross-Tolerance With Co-Administration of Morphine and Fentanyl Into the Periaqueductal Gray of Male Sprague-Dawley Rats.The journal of pain · 2019Article
- Effect of dose escalation with single opioid, fentanyl matrix in patients not controlling cancer pain: a multicenter, prospective, observational study in Korea.Cancer research and treatment · 2013Article
- Preclinical pharmacology and opioid combinations.Pain medicine (Malden, Mass.) · 2012Review
- High-dose fentanyl patch for cancer pain of a patient with cholangiocarcinoma.The Korean journal of internal medicine · 2010Article
- Cellular neuroadaptations to chronic opioids: tolerance, withdrawal and addiction.British journal of pharmacology · 2008Review
- Review
- Promoting science in a pragmatic world: not (yet) time for partial opioid rotation.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2005Article
- Look before leaping: combined opioids may not be the rave.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2005Review
- Gaps and junctions between clinical experience and theoretical framework in the use of opioids.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2004Article
- [Quasi-experimental study of an intervention on the pharmacological management of non-oncological chronic pain in Primary Care].Atencion primariaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recent experimental data suggest a possible use of an opioid combination to improve analgesia. In cancer patients, a rapid opioid escalation due to either worsening of the pain condition or the development of tolerance is a critical phase, as this condition is associated with a negative prognosis. The aim of this study was to assess the effects of adding a second opioid at low doses in patients with a poor analgesic benefit after dose escalation. Fourteen patients receiving strong opioids who had increased their dosage more than 100% in the last week unsuccessfully were randomly chosen to add a second opioid to the first using an initial equivalent dosage of 20% of the previous therapy. The dose of the second opioid was then changed according to the clinical situation to obtain an acceptable pain control with minimal adverse effects. Pain and symptoms associated with opioid therapy were assessed, and an opioid escalation index (OEI) was calculated at weekly intervals. OEI significantly decreased after adding the second opioid, and this trend was also maintained for the following weeks. Similarly, pain intensity was significantly improved and maintained at acceptable levels for the following weeks. The second opioid did not induce significant opioid-related adverse effects. The opioid combination was able to break opioid escalation in patients with pain syndromes with a poor response to the previous opioid. It allowed for a regaining of analgesia, regardless of the opioid combination used. These preliminary observations should be confirmed in further studies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.