PMID- 18950436
OWN - NLM
STAT- MEDLINE
DCOM- 20090113
LR  - 20220330
IS  - 1526-4637 (Electronic)
IS  - 1526-2375 (Linking)
VI  - 9
IP  - 7
DP  - 2008 Oct
TI  - Titration with oxymorphone extended release to achieve effective long-term pain 
      relief and improve tolerability in opioid-naive patients with moderate to severe 
      pain.
PG  - 777-85
LID - 10.1111/j.1526-4637.2007.00390.x [doi]
AB  - OBJECTIVE: Assess the effectiveness and tolerability of a program of gradual dose 
      titration with oxymorphone extended release (ER) for treatment of moderate to 
      severe chronic pain in opioid-naive patients. DESIGN: Open-label, nonrandomized 
      6-month study with a titration/stabilization period of <or=1 month followed by a 
      5-month maintenance period. SETTING: Multidisciplinary pain centers in the United 
      States. PATIENTS: Adult opioid-naive patients with moderate to severe chronic 
      pain. INTERVENTIONS: Patients were gradually titrated from a 5-mg dose of 
      oxymorphone ER (taken every 12 hours) to a stabilized dose that provided 
      effective pain relief and was well tolerated. OUTCOME MEASURES: Brief Pain 
      Inventory Short Form questions 5 and 9, patient and physician global assessments 
      of pain relief, adverse events (AEs), and discontinuations. RESULTS: The majority 
      (94/126; 75%) of patients were stabilized on a dose of oxymorphone ER that 
      provided effective pain relief with tolerable AEs. Most (81/94; 86%) required <24 
      days to reach a stable dose. Sixteen percent of patients in the titration period 
      and 17% of patients in the maintenance period discontinued because of AEs 
      possibly or probably related to oxymorphone ER. Patients completing the entire 
      5-month maintenance period experienced effective pain relief with significant 
      (>50%) reductions of pain interference with quality-of-life measures. There was 
      minimal dose escalation over the 5 months and low use of rescue medication. 
      CONCLUSIONS: Oxymorphone ER provided effective pain relief from moderate to 
      severe chronic pain in opioid-naive patients. Gradual titration was well 
      tolerated, with a low rate of discontinuations caused by AEs.
FAU - Rauck, Richard
AU  - Rauck R
AD  - Carolinas Pain Institute, Wake Forest University, Winston-Salem, North Carolina 
      27103, USA. rrauck@ccrpain.com
FAU - Ma, Tina
AU  - Ma T
FAU - Kerwin, Rosemary
AU  - Kerwin R
FAU - Ahdieh, Harry
AU  - Ahdieh H
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Pain Med
JT  - Pain medicine (Malden, Mass.)
JID - 100894201
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Delayed-Action Preparations)
RN  - 9VXA968E0C (Oxymorphone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analgesics, Opioid/administration & dosage
MH  - Delayed-Action Preparations/administration & dosage
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Drug Tolerance
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Oxymorphone/*administration & dosage/adverse effects
MH  - Pain/*diagnosis/*drug therapy
MH  - Pain Measurement/*drug effects
MH  - Treatment Outcome
MH  - United States
EDAT- 2008/10/28 09:00
MHDA- 2009/01/14 09:00
CRDT- 2008/10/28 09:00
PHST- 2008/10/28 09:00 [pubmed]
PHST- 2009/01/14 09:00 [medline]
PHST- 2008/10/28 09:00 [entrez]
AID - PME390 [pii]
AID - 10.1111/j.1526-4637.2007.00390.x [doi]
PST - ppublish
SO  - Pain Med. 2008 Oct;9(7):777-85. doi: 10.1111/j.1526-4637.2007.00390.x.