Dataset Information

Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled study.

ABSTRACT:

Purpose

Refractory cancer-induced bone pain (CIBP) affects a patient's functional capacity and quality of life, but there is limited evidence to guide opioid choice. We assessed the feasibility, tolerability and possible efficacy of methadone rotation (MR) compared to other opioid rotations (OOR) in this cohort.

Methods

Adults with CIBP and worst pain intensity ≥ 4/10 and/or opioid toxicity graded ≥ 2 on the Common Terminology Criteria for Adverse Events were randomised 1:1 to methadone or another opioid rotation. Standardised assessment tools were used at pre-defined study time points up to 14 days.

Results

Of 51 eligible participants, 38 (74.5%) consented, and 29 (76.3%, MR: 14, OOR: 15) completed the fourteen days follow-up post-opioid rotation. Both groups displayed significant reduction in average (MR: d = - 1.2, p = 0.003, OOR: d = - 0.8, p = 0.015) and worst pain (MR: d = - 0.9, p = 0.042, OOR: d = - 0.6, p = 0.048) and total pain interference score (MR: d = - 1.1, p = 0.042, OOR: d = - 0.7, p = 0.007). Oral morphine equivalent daily dose was reduced significantly in MR compared to the OOR group (d = - 0.8, p = 0.05). The incidence of opioid-related adverse events following MR was unchanged but lower in the OOR group (d = 0.9, 95% CI 0.1,1.7, p = 0.022). There were no within-group or between-group differences in satisfaction with analgesia at the end of the study.

Conclusion

This pilot study demonstrated that MR and OOR in patients with refractory CIBP are feasible, safe and acceptable to patients. Appropriately powered multi-centre randomised controlled studies are needed to confirm the efficacy of MR and OOR in this cohort.

Trial registration

ACTRN12621000141842 registered 11 February 2021.

SUBMITTER: Sulistio M

PROVIDER: S-EPMC11233296 | biostudies-literature | 2024 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled study.

Sulistio Merlina M Gorelik Alexandra A Tee Hoong Jiun HJ Wojnar Robert R Kissane David D Michael Natasha N

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20240709 8

<h4>Purpose</h4>Refractory cancer-induced bone pain (CIBP) affects a patient's functional capacity and quality of life, but there is limited evidence to guide opioid choice. We assessed the feasibility, tolerability and possible efficacy of methadone rotation (MR) compared to other opioid rotations (OOR) in this cohort.<h4>Methods</h4>Adults with CIBP and worst pain intensity ≥ 4/10 and/or opioid toxicity graded ≥ 2 on the Common Terminology Criteria for Adverse Events were randomised 1:1 to met ...[more]

PMID: 38980427

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Dataset Information

Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled study.

Purpose

Methods

Results

Conclusion

Trial registration

Publications

Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled study.

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