SynthesisDeutsches Arzteblatt international2018
Opioid Rotation in Cancer Pain Treatment.
Synthesis in Deutsches Arzteblatt international, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Opioid conversion in adults with cancer: MASCC-ASCO-AAHPM-HPNA-NICSO guideline.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Guideline
- Evaluation of Buprenorphine Rotation in Patients Receiving Long-term Opioids for Chronic Pain: A Systematic Review.JAMA network open · 2021Pooled it
- Hydromorphone for cancer pain.The Cochrane database of systematic reviews · 2021Pooled it
- Different Acupuncture Combined With Three-Step Analgesic Therapy in the Treatment of Bone Metastatic Cancer Pain: A Network Meta-Analysis Based on Randomized Controlled Trials.Pain research & management · 2026Review
- Article
- [Treatment of cancer-related pain-From pharmacotherapy to invasive procedures].Die Anaesthesiologie · 2025Review
- Inadequate Cancer Pain Control after Switching High-Dose Fentanyl to Hydromorphone Injection: A Case Series Highlighting Issues with Conventional Conversion Ratios.Palliative medicine reports · 2025Article
- Parenteral morphine and oxycodone mixtures administered in specialised palliative and hospice care units: A retrospective medical record review.Palliative care and social practice · 2025Article
- Low-dose methadone added to another opioid for cancer pain: a multicentre prospective study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 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
- [Tumor-associated pain].Schmerz (Berlin, Germany) · 2024Article
- Analysis of Opioid-Related Adverse Events in Japan Using FAERS Database.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study.Cancers · 2023Article
- Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques.Current oncology (Toronto, Ont.) · 2023Review
- Dexamethasone to prednisolone rotation relieved hiccups in colorectal cancer patient continuing teleworking during anticancer therapy.Clinical case reports · 2023Article
- Fentanyl in cancer pain management: avoiding hasty judgments and discerning its potential benefits.Drugs in context · 2023Review
- Antitumor Effects of Hydromorphone on Human Gastric Cancer Cells in vitro.Drug design, development and therapy · 2023Article
- Opioid Rotation and Conversion Ratios Used by Palliative Care Professionals: An International Survey.Journal of palliative medicine · 2022Article
- The Role of Pharmacogenomics in Opioid Prescribing.Current treatment options in oncology · 2022Review
- Experience of symptom control, anxiety and associating factors in a palliative care unit evaluated with Support Team Assessment Schedule Japanese version.Scientific reports · 2021Observational
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 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRotating several different WHO level III opioid drugs is a therapeutic option for patients with chronic cancer-related pain who suffer from inadequate analgesia and/or intolerable side effects. The evidence favoring opioid rotation is controversial, and the current guidelines in Germany and other countries contain only weak recommendations for it.
methodsThis review is based on pertinent publications retrieved by a systematic review of the literature on opioid rotation for adult patients with chronic cancerrelated pain who are regularly taking WHO level III opioids by the oral or trans - dermal route.
results9 individual studies involving a total of 725 patients were included in the analysis, and 3 previous systematic reviews of studies involving a total of 2296 patients were also analyzed. Morphine, oxycodone, fentanyl, hydromorphone, and buprenorphine were used as first-line opioid drugs, and hydromorphone, bupre - norphine, tapentadol, fentanyl, morphine, oxymorphone, and methadone were used as second-line opioid drugs. In all of the studies, pain control was achieved for 14 days after each rotation. In most of them, the dose of the new drug introduced in each rotation needed to be increased above the dose initially calculated from a rotation ratio, with the exception of rotations to methadone. The frequency of side effects was only rarely lessened, but patients largely considered the result of opioid rotation to be positive. No particular opioid drug was found to be best.
conclusionOpioid rotation can improve analgesia and patient satisfaction. The success of opioid rotation appears to depend on the magnitude of the initial dose, among other factors. Tables of equianalgesic doses should be considered no more than a rough guide for determining the dose of the new drug. Rotations to methadone should be carried out under clinical supervision in experienced hands.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.