Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2019
Opioid switching and variability in response in pain cancer patients.
Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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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.
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Who cites it
8 citing papers in PubMed, 25 citations in OpenAlex.
- Inter-individual divergence in thresholds for detecting opioid effects: Within-subject human laboratory evidence of a testable behavioral phenotype.Drug and alcohol dependence · 2025Trial
- A systematic review and meta-analysis to identify vertical limits for a high-dose opioid therapy.Neurological research and practice · 2025Review
- Efficacy and safety of combining low-dose methadone with ongoing opioid treatment for uncontrolled cancer pain: an open-label single-arm study.The oncologist · 2025Observational
- Article
- Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study.Cancers · 2023Article
- Integrating pharmacogenomics into precision pain management.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Review
- Role of Cannabidiol for Improvement of the Quality of Life in Cancer Patients: Potential and Challenges.International journal of molecular sciences · 2022Review
- A preliminary study of the effect of naldemedine tosylate on opioid-induced nausea and vomiting.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOpioid switching is a possible strategy for inadequate analgesia or unmanageable side effects. Its effectiveness ranges from 50 to 90% and is still debated. PURPOSE: We analyzed the impact of opioid switching in a cancer pain population treated with strong opioids for pain.
methodsThis is a post hoc analysis from a multicenter, randomized, four-arm, controlled, phase IV clinical trial. Outcome variables included the percentages of switches, the reasons for the switch, the dose changes before and after the switch, depending on the starting opioid, the response in case of inadequate analgesia, and unmanageable toxicity, and the variability of response among and within patients.
resultsWe analyzed 498 patients. The opioid was switched in 79 patients (15.9%) 87 times, mainly for uncontrolled pain (52.3%), adverse opioid reactions (22.1%), both of these (4.8%), and dysphagia (20.8%). The reasons for switching varied depending on the starting opioid. Pain reduction was good after 51.45% of switches and control of opioid side effects was good after 43.5%. The relief of opioid-induced toxicity varied among adverse events and within each patient. The daily doses were higher after switching oral opioids and lower after transdermal drugs.
conclusionsHalf of the patients who underwent switching experienced improved relief of pain or amelioration of opioid toxicity. The switch can help in the management of some cases but with many limits and uncertainties.
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