THE EFFECT OF SUSTAINED-RELEASE MORPHINE ON BREATHLESSNESS AND QUALITY-OF-LIFE IN SEVERE CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Morphine has been proposed as a treatment for breathlessness in patien ts with severe chronic obstructive pulmonary disease (COPD), but there is uncertainty as to whether or not it is effective. Orally administe red sustained-release morphine was compared with placebo in a randomiz ed, double-blind, crossover trial with two 6-wk treatment periods sepa rated by a 2-wk washout period. The primary end point was quality of l ife measured using the Chronic Respiratory Disease Questionnaire (CRQ) . Secondary end points included 6-min walk (6MW), distance, and breath lessness scores. Sixteen subjects with a mean age 70.7 yr, FEV1 of 0.6 L, and VC of 1.90 L were studied. There was no change in the total CR Q score with either treatment, but the score on the Mastery subscale w as significantly worse with morphine (p = 0.02). The 6MW distance incr eased by 21 m from the beginning to the end of the placebo treatment p eriod, but it decreased by 35 m with morphine (p = 0.04). There were n o differences between treatments in breathlessness scored on daily dia ry cards or on the Dyspnea subscale of the CRQ. Almost all the subject s experienced adverse effects related to morphine. Sustained-release m orphine was not a useful treatment for breathlessness in these patient s with severe CORD.