PMID- 34265791
OWN - NLM
STAT- MEDLINE
DCOM- 20210831
LR  - 20230827
IS  - 1536-5409 (Electronic)
IS  - 0749-8047 (Linking)
VI  - 37
IP  - 9
DP  - 2021 Sep 1
TI  - A Randomized Controlled Trial Evaluating the Analgesic Effect of the Combination 
      of Methadone With Morphine for Cancer Related Pain.
PG  - 664-668
LID - 10.1097/AJP.0000000000000959 [doi]
AB  - CONTEXT AND OBJECTIVES: Although opioids play an indispensable role in the 
      management of cancer-related pain, inadequate pain relief still occurs. The 
      primary objective of this study was to evaluate whether the combination of a low 
      dose of methadone with morphine promotes a reduction in opioid consumption; the 
      secondary objectives were if the association promotes lower pain intensity, and 
      adverse effects (AEs). MATERIALS AND METHODS: A sample if 41 patients with 
      cancer-related pain in palliative setting were included. Patients were starting 
      the third step of the analgesic ladder, and 1 group (n=21) achieve methadone 
      (2.5 mg/12 h) in combination with morphine/methadone, and another group (n=20) 
      received morphine alone. Both groups could use morphine (5 mg) as needed to 
      maintain pain intensity <4, and adjuvant in stable dose. The following outcomes 
      were evaluated: total morphine dose, pain intensity, and AEs. RESULTS: There was 
      no difference in the number of adjuvants, and the dose of morphine used. Pain 
      intensity was significantly lower in the morphine/methadone group after 2 weeks, 
      with no statistically significant difference at other timepoints. There was no 
      difference between groups in the AEs. CONCLUSION: Low dose of methadone in 
      combination with morphine provided faster pain control as compared with morphine 
      alone, and although this study was not powered to show differences in AEs, we did 
      not notice a difference.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Duarte, Feliciano C N
AU  - Duarte FCN
AD  - Department of Anesthesia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
FAU - Ferraro, Leonardo H D C
AU  - Ferraro LHDC
FAU - Ferreira, Alessandra
AU  - Ferreira A
FAU - Sakata, Rioko K
AU  - Sakata RK
LA  - eng
SI  - ClinicalTrials.gov/NCT03324815
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Clin J Pain
JT  - The Clinical journal of pain
JID - 8507389
RN  - 0 (Analgesics)
RN  - 0 (Analgesics, Opioid)
RN  - 76I7G6D29C (Morphine)
RN  - UC6VBE7V1Z (Methadone)
SB  - IM
MH  - Analgesics
MH  - Analgesics, Opioid/therapeutic use
MH  - *Cancer Pain/drug therapy
MH  - Humans
MH  - Methadone/therapeutic use
MH  - Morphine/therapeutic use
MH  - *Neoplasms/complications
COIS- Financed in part by the Brazilian Federal Agency for the Support and Evaluation 
      of Graduate Education (CAPES), Sao Paulo, Brazil. The authors declare no conflict 
      of interest.
EDAT- 2021/07/16 06:00
MHDA- 2021/09/01 06:00
CRDT- 2021/07/15 20:34
PHST- 2020/04/30 00:00 [received]
PHST- 2021/06/19 00:00 [accepted]
PHST- 2021/07/16 06:00 [pubmed]
PHST- 2021/09/01 06:00 [medline]
PHST- 2021/07/15 20:34 [entrez]
AID - 00002508-202109000-00004 [pii]
AID - 10.1097/AJP.0000000000000959 [doi]
PST - ppublish
SO  - Clin J Pain. 2021 Sep 1;37(9):664-668. doi: 10.1097/AJP.0000000000000959.