PMID- 24683205
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140331
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 68
IP  - 3
DP  - 2007 May
TI  - Effectiveness of polymer-coated extended-release morphine sulfate capsules in 
      older patients with persistent moderate-to-severe pain: A subgroup analysis of a 
      large, open-label, community-based trial.
PG  - 137-50
LID - 10.1016/j.curtheres.2007.05.002 [doi]
AB  - Abstract. BACKGROUND: Opioid analgesics may offer benefits over nonopioids in 
      some older patients, especially those with moderate-to-severe pain. 
      Polymer-coated extended-release morphine sulfate (P-ERMS) has been found to be 
      efficacious and well tolerated in patients with chronic, moderate-to-severe, 
      nonmalignant pain when used QD or BID. OBJECTIVE: The purpose of this analysis 
      was to determine the effectiveness of P-ERMS in older patients (aged >65 years) 
      with persistent, moderate-to-severe, inadequately controlled, nonmalignant pain. 
      METHODS: This was a subgroup analysis of the older population from an openlabel 
      trial in community-based pain clinics in which patients underwent treatment with 
      P-ERMS for persistent, moderate-to-severe, inadequately controlled, nonmalignant 
      pain (>/=4 on a scale of 0-10). Patients received P-ERMS at a dose determined by 
      the investigator based on their previous analgesic regimen, QD (morning or 
      evening) for a 4-week treatment period. Dose increases were permitted after weeks 
      1 and 2; switching to BID was allowed after week 2, if needed. Measurements 
      included changes in pain and sleep scores (0-10 scale), quality of life (QOL) 
      scores (physical and mental component summaries [PCS and MCS, respectively] of 
      the 36-Item Short-Form Health Survey instrument), and patient and clinician 
      assessments of current treatment based on a 9-point scale ranging from -4 to +4. 
      RESULTS: One hundred forty-eight older patients (mean [SD]age, 73.4 [5.5] years) 
      began treatment with P-ERMS; 86 (58.1%) of those patients completed the study. 
      Pain and sleep scores significantly improved (decreased) from baseline to week 4 
      (7.4 vs 5.0 and 5.0 vs 3.2, respectively; both, P < 0.001). PCS and MCS scores 
      significantly improved (increased) from baseline (27.7 vs 31.6 and 37.6 vs 40.8, 
      respectively; both, P < 0.05), as did patient and clinician global assessments 
      (-1.2 vs 1.1 and -1.5 vs 1.4; both, P < 0.001). Results found in these older 
      patients were similar to those observed in the younger patients (aged </=65 years). 
      A majority (71.4%) of the older patients remained on QD administration and took 
      significantly lower mean daily doses than younger patients (77.0 vs 105.2 mg/d, 
      respectively; P = 0.001). The dropout rate for the subgroup was 41.1%, which was 
      similar to that reported in previous studies in mixed-age populations taking 
      other extended-release morphine formulations. Of the patients who discontinued (n 
      = 60), adverse events (AEs) were the most prevalent reason (n = 29). The most 
      common treatment-related AEs were constipation (19.6%) and nausea (9.5%). 
      CONCLUSIONS: This subgroup analysis of a previously published study revealed that 
      the older patients in that study who were receiving P-ERMS for persistent, 
      moderate-to-severe, inadequately controlled, nonmalignant pain who completed the 
      study attained significant improvements in pain, sleep, and QOL scores compared 
      with baseline. Patient and clinician satisfaction with treatment increased 
      significantly from baseline to study end. Older patients utilized significantly 
      lower mean daily doses than younger patients (P < 0.001), and >70% remained on a 
      QD administration regimen for the duration of the study.
FAU - Sasaki, John
AU  - Sasaki J
AD  - Casa Colina Centers for Rehabilitation, Pomona, California, USA.
FAU - Weil, Arnold J
AU  - Weil AJ
AD  - Non-Surgical Orthopedic & Spine Center, PC, Atlanta, Georgia, USA.
FAU - Ross, Edgar L
AU  - Ross EL
AD  - Pain Management Center, Brigham and Women's Hospital, Boston, Massachusetts, USA.
FAU - Nicholson, Bruce D
AU  - Nicholson BD
AD  - Division of Pain Medicine, Lehigh Valley Hospital & Health Network, Allentown, 
      Pennsylvania, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3967290
OTO - NOTNLM
OT  - KADIAN
OT  - analgesia
OT  - morphine
OT  - nonmalignant pain
OT  - persistent pain
EDAT- 2007/05/01 00:00
MHDA- 2007/05/01 00:01
PMCR- 2007/05/01
CRDT- 2014/04/01 06:00
PHST- 2007/02/08 00:00 [accepted]
PHST- 2014/04/01 06:00 [entrez]
PHST- 2007/05/01 00:00 [pubmed]
PHST- 2007/05/01 00:01 [medline]
PHST- 2007/05/01 00:00 [pmc-release]
AID - S0011-393X(07)00047-1 [pii]
AID - 10.1016/j.curtheres.2007.05.002 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2007 May;68(3):137-50. doi: 
      10.1016/j.curtheres.2007.05.002.