The objective of this study was to evaluate the outcomes associated with the
use of controlled-release (CR) oxycodone for up to 3 years in the treatment
of noncancer pain. Adult patients who previously participated in controlled
trials of CR oxycodone for osteoarthritis pain, diabetic neuropathy pain, or
low back pain, and who continued to require opioid analgesia for moderate or
severe pain, were enrolled in an open-label, uncontrolled, registry study. Data
collected over time included dose, pain severity on a numeric scale, treatment
acceptability, adverse events, and descriptions of problematic drug-related
behavior.
Two hundred thirty-three patients were enrolled. When the study closed, 141,
86, and 39 patients had taken CR oxycodone for at least 1, 2, and 3 years, respectively;
mean duration of treatment was 541.5 days. Among the 219 intent-to-treat patients
(received at least 1 dose and provided at least 1 postdose study observation),
the mean daily dose was 52.5 mg. Before the end of Month 3, 44% required an
increase in total daily dose; this dropped to 23% during Months 4 to 6, to 17%
during Months 10 to 12, and remained at approximately 10% for each time interval
thereafter. Among the large majority of patients with stable or lower dose requirements
after the initial 3 months of treatment, the average pain intensity ratings
were unchanged or improved for approximately 70% to 80% of patients at all subsequent
time points through Month 33, and for 54% at Month 36. A decrease in pain was
initially seen by the end of Month 3, and for the majority of patients, the
Average Pain Intensity score remained the same, better, or minimally worse (<3
points) for the remainder of the 3-year study period. The most common adverse
events were constipation and nausea, and the incidence of these events declined
over time on treatment. Investigators reported 6 cases of possible drug misuse
but no evidence of de novo addiction was observed.
These registry data demonstrate that a subgroup of patients with noncancer
pain experienced prolonged relief with tolerable side effects and modest need
for dose escalation during long-term therapy with CR oxycodone. Portenoy RK,
Farrar JT, Backonja MM, Cleeland CS, Yang K, Friedman M, Colucci SV, Richards
P. Adapted from Clin J Pain. 2007 May;23(4):287-299.
PMID: 17449988
Read More:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the
National Library of Medicine (NLM).
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