Trial reportHealth technology assessment (Winchester, England)2026
Comparing the effectiveness, cost-effectiveness and implementation of low-dose oral modified release morphine in people with chronic breathlessness: a synopsis of a RCT and process evaluation.
Trial report in Health technology assessment (Winchester, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Chronic breathlessness is common and disabling in chronic medical conditions. There is good rationale to use opioids from neuroscience and exercise laboratory studies. Objectives: We assessed the 56-day effectiveness, cost-consequences and safety of long-acting oral morphine for breathlessness in people with cardio-respiratory diseases or cancer. Methods: We conducted a parallel-group, randomised, placebo-controlled trial in 11 UK outpatient services, comparing 10-20 mg daily oral morphine with placebo (and blinded laxative) in people with moderate to severe breathlessness, with embedded health economic evaluation. The primary outcome was Results: Between 18 March 2021 and 26 October 2023, 143 were randomised (75 morphine, 68 placebo); 140 formed the modified intention-to-treat population [90% power; males 66%; mean age 70.5 (standard deviation 9.4)]. By day 28, 60/73 (82%) morphine Limitations: Interpretation is cautious, but findings are plausible and consistent with other evidence. We infer improved exercise endurance. Most participants had chronic lung disease and minoritised ethnic communities are under-represented. Conclusion: We found no evidence that morphine improved Future work: Further research is needed to understand if there is any role of morphine in chronic breathlessness, but our findings do not support its use in this setting. Future studies should consider physical activity levels (actigraphy), exercise endurance (isotime/isoload breathlessness measures) or cough as the primary outcome. We need better representation from minoritised ethnic communities and people with heart failure. Funding: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 17/34/01.
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