COMPARATIVE EFFICACY AND SAFETY OF CONTROLLED-RELEASE MORPHINE SUPPOSITORIES AND TABLETS IN CANCER PAIN

Although the oral route is the preferred method of opioid therapy in p atients with cancer pain, many patients will require an alternate rout e of analgesic administration at some point during the trajectory of t heir illness. This study compared the efficacy and safety of a novel, controlled-release suppository of morphine (MSC-R) and controlled-rele ase morphine tablets (MSC-T) in patients with cancer pain. In a double -blind crossover study, 27 patients with cancer pain were randomized t o receive MSC-R or MSC-T every 12 hours for 7 days each, using a 1:1 a nalgesic equivalence ratio. Pain intensity was assessed using a visual analog scale (VAS) and the Present Pain Intensity Index of the McGill Pain Questionnaire. Nausea and sedation were also assessed with a VAS . Pharmacodynamic assessments were made by the patient at 8:00 AM, 12: 00 PM, 4:00 PM, and 8:00 PM and rescue morphine use recorded in a dail y diary. There were no significant differences between MSC-R and MSC-T in overall scores for pain intensity VAS, ordinal pain intensity, and sedation. There was a small but significant difference in overall nau sea VAS score in favor of MSC-R. Mean daily rescue analgesic use did n ot differ significantly during between treatment with MSC-R and MSC-T. MSC-R provides pain control comparable to that provided by MSC-T when given every 12 hours al a 1:1 dose ratio, and represents a reliable a lternative method of pain control for patients unable to take oral opi oid agents.