PMID- 31732660
OWN - NLM
STAT- MEDLINE
DCOM- 20211122
LR  - 20220531
IS  - 2045-4368 (Electronic)
IS  - 2045-435X (Linking)
VI  - 11
IP  - 4
DP  - 2021 Dec
TI  - Morphine for dyspnoea in chronic obstructive pulmonary disease: a before-after 
      efficacy study.
PG  - 427-432
LID - 10.1136/bmjspcare-2019-001929 [doi]
AB  - OBJECTIVES: Dyspnoea in patients with chronic obstructive pulmonary disease 
      (COPD) is frequent and often persists despite conventional treatment. This study 
      aimed to evaluate the efficacy and safety of oral morphine for dyspnoea in 
      Japanese COPD patients. METHODS: We conducted a multi-institutional, prospective, 
      before-after study of morphine in COPD patients with dyspnoea at rest in seven 
      hospitals. Patients received 12 mg of oral morphine per day (or 8 mg per day if 
      low body weight or renal impairment). Primary outcome was change in the numerical 
      rating scale (NRS) of current dyspnoea in the evening from Day 0 to Day 2. 
      Secondary outcomes included changes in dyspnoea intensity in the evening from Day 
      0 to Day 1, dyspnoea intensity between the morning from Day 0 to Day 1 and Day 2, 
      vital signs, nausea, somnolence, anorexia and other adverse events (AEs). 
      RESULTS: A total of 35 patients were enrolled in this study between October 2014 
      and January 2018. One patient did not receive study treatment. Data from 34 
      patients was analysed. The NRS of dyspnoea intensity in the evening significantly 
      decreased from 3.9 on Day 0 (95% CI: 3.1 to 4.8) to 2.4 on Day 2 (95% CI: 1.7 to 
      3.1; p=0.0002). Secondary outcomes significantly improved in a similar manner. 
      There were no apparent changes in the mean scores of the opioid-related AEs and 
      vital signs. One patient experienced grade 3 lung infection not associated with 
      morphine. Other AEs were mild. CONCLUSION: Oral morphine is effective in 
      alleviating dyspnoea in Japanese COPD patients. Trial registration UMIN000015288 
      (http://www.umin.ac.jp/ctr/index.htm).
CI  - (c) Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Matsuda, Yoshinobu
AU  - Matsuda Y
AUID- ORCID: 0000-0001-5092-9377
AD  - Department of Psychosomatic Internal Medicine, Kinki Chuo Chest Medical Center, 
      Sakai, Japan matsuda.yoshinobu.tx@mail.hosp.go.jp.
FAU - Morita, Tatsuya
AU  - Morita T
AD  - Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, 
      Hamamatsu City, Shizuoka, Japan.
FAU - Matsumoto, Hirotaka
AU  - Matsumoto H
AD  - Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical 
      Center, Amagasaki, Japan.
FAU - Hosoi, Keita
AU  - Hosoi K
AD  - Department of Respiratory Medicine, Itami City Hospital, Itami, Japan.
FAU - Kusama, Kayo
AU  - Kusama K
AD  - Department of Respiratory Medicine, Sakai City Medical Center, Sakai, Japan.
FAU - Kohashi, Yasuo
AU  - Kohashi Y
AD  - Department of Respiratory Medicine, HARUHI Respiratory Medical Hospital, Kiyosu, 
      Japan.
FAU - Morishita, Hiroshi
AU  - Morishita H
AD  - Department of Respiratory Medicine, Osaka Habikino Medical Center, Habikino, 
      Japan.
FAU - Kaku, Sawako
AU  - Kaku S
AD  - Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, 
      Hamamatsu, Amagasaki, Japan.
FAU - Ariyoshi, Keisuke
AU  - Ariyoshi K
AD  - Department of Data Management, JORTC Data Center, Tokyo, Japan.
FAU - Oyamada, Shunsuke
AU  - Oyamada S
AD  - Department of Biostatistics, JORTC Data Center, Tokyo, Japan.
FAU - Inoue, Yoshikazu
AU  - Inoue Y
AD  - Clinical Research Center National Hospital Organization Kinki-Chuo Chest Medical 
      Center, Sakai, Japan.
FAU - Iwase, Satoru
AU  - Iwase S
AD  - Department of Palliative Medicine, Saitama Medical University, Moroyama, Japan.
FAU - Yamaguchi, Takuhiro
AU  - Yamaguchi T
AD  - Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, 
      Miyagi, Japan.
FAU - Nishikawa, Mitsunori
AU  - Nishikawa M
AD  - Department of Palliative Care, National Center for Geriatrics and Gerontology, 
      Obu, Japan.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
DEP - 20191115
PL  - England
TA  - BMJ Support Palliat Care
JT  - BMJ supportive & palliative care
JID - 101565123
RN  - 0 (Analgesics, Opioid)
RN  - 76I7G6D29C (Morphine)
SB  - IM
MH  - Analgesics, Opioid/therapeutic use
MH  - Dyspnea/drug therapy/etiology
MH  - Humans
MH  - *Morphine/therapeutic use
MH  - Prospective Studies
MH  - *Pulmonary Disease, Chronic Obstructive/complications/drug therapy
OTO - NOTNLM
OT  - clinical trials and COPD
OT  - dyspnoea
OT  - morphine
COIS- Competing interests: None declared.
EDAT- 2019/11/17 06:00
MHDA- 2021/11/23 06:00
CRDT- 2019/11/17 06:00
PHST- 2019/06/19 00:00 [received]
PHST- 2019/08/07 00:00 [revised]
PHST- 2019/11/04 00:00 [accepted]
PHST- 2019/11/17 06:00 [pubmed]
PHST- 2021/11/23 06:00 [medline]
PHST- 2019/11/17 06:00 [entrez]
AID - bmjspcare-2019-001929 [pii]
AID - 10.1136/bmjspcare-2019-001929 [doi]
PST - ppublish
SO  - BMJ Support Palliat Care. 2021 Dec;11(4):427-432. doi: 
      10.1136/bmjspcare-2019-001929. Epub 2019 Nov 15.