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Regular, sustained-...
Regular, sustained-release morphine for chronic breathlessness : A multicentre, double-blind, randomised, placebo-controlled trial
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- Currow, David (författare)
- Flinders University,University of Technology Sydney
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- Louw, Sandra (författare)
- McCloud Consulting Group
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- McCloud, Philip (författare)
- McCloud Consulting Group
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- Fazekas, Belinda (författare)
- Flinders University,University of Technology Sydney
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- Plummer, John (författare)
- Flinders University
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- McDonald, Christine F. (författare)
- University of Melbourne,Austin Health
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- Agar, Meera (författare)
- University of Technology Sydney
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- Clark, Katherine (författare)
- University of Sydney,St George Hospital, Sidney
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- McCaffery, Nikki (författare)
- Deakin University,Flinders University
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- Ekström, Magnus Pär (författare)
- Lund University,Lunds universitet,Lungmedicin, allergologi och palliativ medicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Andfåddhet och kronisk andningssvikt,Forskargrupper vid Lunds universitet,Respiratory Medicine, Allergology, and Palliative Medicine,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Breathlessness and chronic respiratory failure,Lund University Research Groups,University of Technology Sydney
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(creator_code:org_t)
- 2019-09-26
- 2020
- Engelska 7 s.
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Ingår i: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 75:1, s. 50-56
- Relaterad länk:
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http://dx.doi.org/10...
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https://thorax.bmj.c...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Introduction Morphine may decrease the intensity of chronic breathlessness but data from a large randomised controlled trial (RCT) are lacking. This first, large, parallel-group trial aimed to test the efficacy and safety of regular, low-dose, sustained-release (SR) morphine compared with placebo for chronic breathlessness. Methods Multisite (14 inpatient and outpatient cardiorespiratory and palliative care services in Australia), parallel-arm, double-blind RCT. Adults with chronic breathlessness (modified Medical Research Council≥2) were randomised to 20 mg daily oral SR morphine and laxative (intervention) or placebo and placebo laxative (control) for 7 days. Both groups could take ≤6 doses of 2.5 mg, â € as needed', immediate-release morphine (≤15 mg/24 hours) as required by the ethics review board. The primary endpoint was change from baseline in intensity of breathlessness now (0-100 mm visual analogue scale; two times per day diary) between groups. Secondary endpoints included: worst, best and average breathlessness; unpleasantness of breathlessness now, fatigue; quality of life; function; and harms. Results Analysed by intention-to-treat, 284 participants were randomised to morphine (n=145) or placebo (n=139). There was no difference between arms for the primary endpoint (mean difference -0.15 mm (95% CI -4.59 to 4.29; p=0.95)), nor secondary endpoints. The placebo group used more doses of oral morphine solution during the treatment period (mean 8.7 vs 5.8 doses; p=0.001). The morphine group had more constipation and nausea/vomiting. There were no cases of respiratory depression nor obtundation. Conclusion No differences were observed between arms for breathlessness, but the intervention arm used less rescue immediate-release morphine. Trial registration number ACTRN12609000806268.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
Nyckelord
- chronic breathlessness
- placebo study
- randomised controlled trial
- sustained release morphine
- symptom relief
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Thorax
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Currow, David
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Louw, Sandra
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McCloud, Philip
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Fazekas, Belinda
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Plummer, John
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McDonald, Christ ...
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Agar, Meera
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Clark, Katherine
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McCaffery, Nikki
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Ekström, Magnus ...
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