PMID- 36641006
OWN - NLM
STAT- MEDLINE
DCOM- 20230418
LR  - 20230624
IS  - 1873-6513 (Electronic)
IS  - 0885-3924 (Linking)
VI  - 65
IP  - 5
DP  - 2023 May
TI  - Systemic Opioids for Dyspnea in Cancer Patients: A Real-world Observational 
      Study.
PG  - 400-408
LID - S0885-3924(23)00004-0 [pii]
LID - 10.1016/j.jpainsymman.2022.12.146 [doi]
AB  - CONTEXT: Although Systemic opioids are recommended as a pharmacological treatment 
      for cancer-related dyspnea, their effectiveness and safety needs to be 
      investigated in a real-world context OBJECTIVES: To evaluate the effectiveness 
      and safety of systemic regular opioids for dyspnea in cancer patients, in the 
      real-world palliative care practice. METHODS: This was a multicenter prospective 
      observational study. We consecutively enrolled adult cancer patients starting 
      regular opioids (morphine, oxycodone, hydromorphone, or fentanyl) for dyspnea 
      from 12 palliative care services across Japan. We evaluated dyspnea intensity 
      using the Numerical Rating Scale (NRS) and Integrated Palliative Outcome Scale 
      (IPOS) every 24 hours until 72 hours after starting opioids (T1-T3). We also 
      evaluated common opioid-related adverse events (AEs) and other severe AEs. 
      RESULTS: We enrolled 402 cancer patients. The proportion of responders was 68.8% 
      (95%confidence intervals (CI): 0.63-0.74) at T1, 75.7% (95%CI: 0.70-0.81) at T2, 
      and 82.1% (95%CI: 0.76-0.87) at T3. The mean differences in dyspnea NRS from 
      baseline were 1.73 (95%CI: 1.46-1.99) at T1, 1.99 (95%CI: 1.71-2.28) at T2, and 
      2.47 (95%CI:2.13-2.82) at T3. The most common treatment-emergent AE was 
      somnolence with an incidence of the severe form of approximately 10% throughout 
      the study period. In the multivariate analysis, baseline dyspnea NRS >/=6 had a 
      positive correlation with dyspnea relief by systemic regular opioids, while liver 
      metastasis, clinician-predicted survival days, and opioid tolerance had a 
      negative correlation. CONCLUSION: Regular systemic opioids were effective for 
      dyspnea in real-world cancer patients.
CI  - Copyright (c) 2023. Published by Elsevier Inc.
FAU - Yamaguchi, Takashi
AU  - Yamaguchi T
AD  - Department of Palliative Medicine, Kobe University Graduate School of Medicine 
      (T.Y.), Kobe, Japan. Electronic address: ikagoro@pop06.odn.ne.jp.
FAU - Matsunuma, Ryo
AU  - Matsunuma R
AD  - Department of Palliative Care, Konan Hospital (R.M., J.T.), Kobe, Japan.
FAU - Matsuda, Yoshinobu
AU  - Matsuda Y
AD  - Department of Psychosomatic Internal Medicine, Kinki-Chuo Chest Medical Center 
      (Y.M.), Sakai, Japan.
FAU - Tasaki, Junichi
AU  - Tasaki J
AD  - Department of Palliative Care, Konan Hospital (R.M., J.T.), Kobe, Japan.
FAU - Ikari, Tomoo
AU  - Ikari T
AD  - Department of Palliative Medicine, Tohoku University School of Medicine (T.I.), 
      Sendai, Japan; Department of Respiratory Medicine, Hokkaido University Faculty of 
      Medicine and Graduate School of Medicine (T.I.), Sapporo, Japan.
FAU - Miwa, Satoru
AU  - Miwa S
AD  - Seirei Hospice, Seirei Mikatahara General Hospital (S.M.), Hamamatsu, Japan.
FAU - Aiki, Sayo
AU  - Aiki S
AD  - Department of Palliative Medicine, National Hospital Organization Osaka Medical 
      Center (S.A.), Osaka, Japan.
FAU - Takagi, Yusuke
AU  - Takagi Y
AD  - Department of Palliative Medicine, Teikyo University School of Medicine ( Y.T.), 
      Tokyo, Japan.
FAU - Kiuchi, Daisuke
AU  - Kiuchi D
AD  - Department of Palliative Care, Center Hospital of the National Center for Global 
      Health and Medicine (D.K.), Tokyo, Japan.
FAU - Suzuki, Kozue
AU  - Suzuki K
AD  - Department of Palliative Care, Tokyo Metropolitan Cancer and Infectious Disease 
      Center Komagome Hospital (K.S.), Tokyo, Japan.
FAU - Oyamada, Shunsuke
AU  - Oyamada S
AD  - Japanese Organisation for Research and Treatment of Cancer (JORTC) (S.O., K.A., 
      K.K.), Tokyo, Japan.
FAU - Ariyoshi, Keisuke
AU  - Ariyoshi K
AD  - Japanese Organisation for Research and Treatment of Cancer (JORTC) (S.O., K.A., 
      K.K.), Tokyo, Japan.
FAU - Kihara, Kota
AU  - Kihara K
AD  - Japanese Organisation for Research and Treatment of Cancer (JORTC) (S.O., K.A., 
      K.K.), Tokyo, Japan.
FAU - Mori, Masanori
AU  - Mori M
AD  - Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital 
      (M.M.), Hamamatsu, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20230111
PL  - United States
TA  - J Pain Symptom Manage
JT  - Journal of pain and symptom management
JID - 8605836
RN  - 0 (Analgesics, Opioid)
RN  - 76I7G6D29C (Morphine)
RN  - CD35PMG570 (Oxycodone)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Analgesics, Opioid/adverse effects
MH  - Drug Tolerance
MH  - Morphine/therapeutic use
MH  - Oxycodone/therapeutic use
MH  - Dyspnea/drug therapy/etiology
MH  - *Neoplasms/complications/drug therapy
OTO - NOTNLM
OT  - Dyspnea
OT  - cancer
OT  - opioid
OT  - palliative care
OT  - real-world
EDAT- 2023/01/15 06:00
MHDA- 2023/04/18 06:41
CRDT- 2023/01/14 19:26
PHST- 2022/10/24 00:00 [received]
PHST- 2022/12/19 00:00 [revised]
PHST- 2022/12/24 00:00 [accepted]
PHST- 2023/04/18 06:41 [medline]
PHST- 2023/01/15 06:00 [pubmed]
PHST- 2023/01/14 19:26 [entrez]
AID - S0885-3924(23)00004-0 [pii]
AID - 10.1016/j.jpainsymman.2022.12.146 [doi]
PST - ppublish
SO  - J Pain Symptom Manage. 2023 May;65(5):400-408. doi: 
      10.1016/j.jpainsymman.2022.12.146. Epub 2023 Jan 11.