Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2010
Early switching from morphine to methadone is not improved by acetaminophen in the analgesia of oncologic patients: a prospective, randomized, double-blind, placebo-controlled study.
Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04779567 (Randomized Double-blind Controlled Study to Assess the Efficacy of Intravenous Acetaminophen Associated With Strong Opioids in the Management of Acute Pain in Adult Cancer Patients), which is not on this map. Cited by 12 papers, 4 of them syntheses that pooled it.
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.
Randomized Double-blind Controlled Study to Assess the Efficacy of Intravenous Acetaminophen Associated With Strong Opioids in the Management of Acute Pain in Adult Cancer Patients
Who cites it
12 citing papers in PubMed, 4 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Systematic review and meta-analysis on non-opioid analgesics in palliative medicine.Journal of cachexia, sarcopenia and muscle · 2018Pooled it
- Paracetamol (acetaminophen) for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Oral paracetamol (acetaminophen) for cancer pain.The Cochrane database of systematic reviews · 2017Pooled it
- Methadone for cancer pain.The Cochrane database of systematic reviews · 2017Pooled it
- Article
- Methadone Conversion Using a 3-Day Switch Strategy in Patients with Cancer on High-Dose Opioids: A Retrospective Study.Pain and therapy · 2024Article
- Opioid analgesic dose and route conversion ratio studies: a scoping review to inform an eDelphi guideline.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Methadone rotation versus other opioid rotation for refractory cancer induced bone pain: protocol of an exploratory randomised controlled open-label study.BMC palliative care · 2023Article
- Article
- Review
- Pharmacological options for the management of refractory cancer pain-what is the evidence?Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2015Review
- Methadone in Cancer Pain.Indian journal of palliative careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aims to evaluate the efficacy of methadone as substitute for morphine and to investigate if the addition of acetaminophen could reduce the time to attain an equianalgesic dose of methadone and/or to improve the level of pain control in oncologic patients. PATIENTS AND
methodsFifty patients on stable doses of morphine for 1 week were switched to methadone using a "stop-start" strategy and randomized in a double-blind fashion to receive either acetaminophen (750 mg PO every 6 hours) or placebo for a 7-day period. We collected data regarding level of pain, side effects, and quality of life.
resultsSubstitution of morphine for methadone resulted in a significant reduction in constipation (p < 0.001) and xerostomia (p = 0.03). There was also an improvement in the numeric pain scale (p = 0.03) as well as a significant improvement in the functional level and symptomatology according to the QLQ-C30 questionnaire. Addition of acetaminophen did not improve pain control or reduce the time of stabilization of analgesia once methadone was introduced. At the end of the study, most patients (70.8%, p = 0.001) preferred methadone to morphine.
conclusionsEarly switching from morphine to methadone was a safe and efficient strategy for the reduction of side effects and improvement of analgesia, allowing for a comfortable dosing regimen. In this scenario, the association with acetaminophen did not improve pain control or reduce the time to achieve an equianalgesic dose of methadone.
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