Evidence map›Paper›PMID 28860712›Full record

Trial reportDrug design, development and therapy2017

A comparison of oral controlled-release morphine and oxycodone with transdermal formulations of buprenorphine and fentanyl in the treatment of severe pain in cancer patients.

Krzysztof Nosek, Wojciech Leppert, Hanna Nosek, Jerzy Wordliczek, Dariusz Onichimowski

Open access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Drug design, development and therapy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.

  1. Oxycodone for cancer-related pain.The Cochrane database of systematic reviews · 2022
    Pooled it
  2. Article
  3. Review
  4. Management of Fatigue in Patients with Advanced Cancer.Current treatment options in oncology · 2023
    Review
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 3 countries.

Krzysztof NosekNon-public Saint Lazarius Health Care Unit, Biskupiec.
Wojciech LeppertChair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznań.
Hanna NosekDepartment of Paediatrics, Regional Children Specialized Hospital, Olsztyn.
Jerzy WordliczekDepartment of Interdisciplinary Intensive Care, Jagiellonian University College of Medicine, Kraków.
Dariusz OnichimowskiDepartment of Intensive Care, Regional Hospital, Olsztyn, Poland.
Children's Specialized Hospital · USJagiellonian University · PLNational Institute of Public Health · GWPoznan University of Medical Sciences · PLUniversity of Computer Sciences and Economics in Olsztyn · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aim of the studyTo compare analgesia and adverse effects during oral morphine and oxycodone and transdermal fentanyl and buprenorphine administration in cancer patients with pain. PATIENTS AND

methodsCancer patients treated at home and in outpatient clinics with severe pain (numerical rating scale score 6-10) fail to respond to non-opioids and/or weak opioids. All patients were randomized to either morphine, oxycodone, fentanyl or buprenorphine and divided into subgroups with predominant neuropathic and nociceptive pain component. Doses of opioids were titrated to satisfactory analgesia and acceptable adverse effects intensity. Patients were assessed at baseline and followed for 28 days. In all patient groups, immediate-release oral morphine was the rescue analgesic and lactulose 10 mL twice daily was the prophylaxis of constipation; no antiemetics were used as prophylaxis.

resultsA total of 62 patients participated and 53 patients completed the study. Good analgesia was obtained for all 4 opioids, for both nociceptive and neuropathic pain. The use of co-analgesics was greater in patients with neuropathic pain. Morphine treatment was associated with less negative impact of pain on ability to walk, work and activity (trend) according to Brief Pain Inventory-Short Form scores and less consumption of rescue morphine. The most common adverse effects included nausea and drowsiness, which increased at the beginning of the treatment and gradually decreased over the days to come. Appetite, well-being, anxiety, depression, and fatigue improved. There was no constipation (the Bowel Function Index scores were within normal range) during the treatment with all opioids. No changes were seen for constipation, vomiting and dyspnea.

conclusionAll opioids were effective and well-tolerated. Morphine was the most effective in the improvement in some of the Brief Pain Inventory-Short Form items regarding negative impact of pain on patients' daily activities. Prophylaxis of constipation was effective; antiemetics may be considered for nausea prevention.

Indexed as

Administration, CutaneousAdministration, OralAgedAged, 80 and overAnalgesics, OpioidBuprenorphineCancer PainConstipationDelayed-Action PreparationsDrug Therapy, CombinationFentanylHumansLactuloseMaleMiddle AgedMorphineAnalgesics, OpioidBuprenorphineDelayed-Action PreparationsFentanylLactuloseMorphineOxycodoneadverse effectsanalgesiaopioid analgesicstreatment

Identifiers

PMID28860712
PMCPMC5574595
OpenAlexW2748693745

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.