News - Once Daily Morphine Sulphate (Avinza) Relieves Chronic Pain Better than Twice Daily Oxycodone (OxyContin): Presented at AAPM

[Guest guest]

Once Daily Morphine Sulphate (Avinza) Relieves Chronic Pain Better

than Twice Daily Oxycodone (OxyContin): Presented at AAPM

By Crystal Phend

SAN DIEGO, C.A. -- March 1, 2006 -- Opioid naïve patients with

chronic low back pain may get better relief from once daily morphine

sulfate (Avinza) than twice daily oxycodone (OxyContin), according to

a study presented here at the annual meeting of the American Academy

of Pain Management (AAPM).

Morphine treated patients also had significantly lower daily morphine-

equivalent doses compared to those in the oxycodone group.

" You don't need to give as much opioid [with morphine sulfate]], and

it's always better to give less opioid, " said co-author

Ghalie, MD, Vice President of Medical Affairs, Ligand

Pharmaceuticals, San Diego, California, United States, in a

presentation on February 23rd.

In the open-label study, opioid-naïve patients with moderate to

severe chronic low back pain were randomized to receive oxycodone or

morphine sulfate. The 266 patients who completed the dose titration

phase went on to the 8 week evaluation phase.

Of these, 174 entered the optional 4 month extension phase.

Demographics in the extension phase were statistically different in

the morphine and oxycodone groups: 68% versus 84% were Caucasian, 9

versus 7 years average duration of back pain, 23% versus 11% non-

mechanical cause of back pain, and 43% versus 28% with nerve

involvement, respectively.

The average morphine dose was 86 mg; the average daily oxycodone dose

was 79.5 mg. Using the American Pain Society's conversion factor,

patients in the oxycodone group received significantly more opioid

daily (119 mg vs. 86 mg).

Brief pain inventory scores reported at monthly office visits were

similar between treatment groups, Dr. Ghalie said.

Absolute changes in pain scores from baseline were about 1 point

lower on a 10 point scale at the second, third and fourth monthly

visits for patients in the morphine group, but this difference was

significant only at the second and third visits. Dr. Ghalie said this

finding narrowly missed significance at month 4 because the number of

patients was getting smaller.

Sleep scores on the Pittsburg Sleep Quality Index were consistently

lower for the morphine group, while the relative change from baseline

on the same index was significantly better at month 1, according to

Dr. Ghalie.

Patients in the two groups reported similar incidence and severity of

adverse effects.

Dr. Ghalie said both drugs clearly work well, but one reason for

differences in outcomes between the groups is that about a third of

patients typically need three times daily dosing for oxycodone rather

than the twice daily dosing indicated on the label.

[Guest guest]

dear paula i take 30mg. and 15mg. morphine sulp. twice a day . is that the same

thing you're talking about here. i have to take vicodin 7.5/750 at least

tiwce a day. it saids every 6 hrs. just want some info about it. if i could take

less pills and get better pain management it would be GREAT.. thank

you mike

a Papola <a54@...> wrote: Once Daily Morphine Sulphate

(Avinza) Relieves Chronic Pain Better

than Twice Daily Oxycodone (OxyContin): Presented at AAPM

By Crystal Phend

SAN DIEGO, C.A. -- March 1, 2006 -- Opioid naïve patients with

chronic low back pain may get better relief from once daily morphine

sulfate (Avinza) than twice daily oxycodone (OxyContin), according to

a study presented here at the annual meeting of the American Academy

of Pain Management (AAPM).

Morphine treated patients also had significantly lower daily morphine-

equivalent doses compared to those in the oxycodone group.

" You don't need to give as much opioid [with morphine sulfate]], and

it's always better to give less opioid, " said co-author

Ghalie, MD, Vice President of Medical Affairs, Ligand

Pharmaceuticals, San Diego, California, United States, in a

presentation on February 23rd.

In the open-label study, opioid-naïve patients with moderate to

severe chronic low back pain were randomized to receive oxycodone or

morphine sulfate. The 266 patients who completed the dose titration

phase went on to the 8 week evaluation phase.

Of these, 174 entered the optional 4 month extension phase.

Demographics in the extension phase were statistically different in

the morphine and oxycodone groups: 68% versus 84% were Caucasian, 9

versus 7 years average duration of back pain, 23% versus 11% non-

mechanical cause of back pain, and 43% versus 28% with nerve

involvement, respectively.

The average morphine dose was 86 mg; the average daily oxycodone dose

was 79.5 mg. Using the American Pain Society's conversion factor,

patients in the oxycodone group received significantly more opioid

daily (119 mg vs. 86 mg).

Brief pain inventory scores reported at monthly office visits were

similar between treatment groups, Dr. Ghalie said.

Absolute changes in pain scores from baseline were about 1 point

lower on a 10 point scale at the second, third and fourth monthly

visits for patients in the morphine group, but this difference was

significant only at the second and third visits. Dr. Ghalie said this

finding narrowly missed significance at month 4 because the number of

patients was getting smaller.

Sleep scores on the Pittsburg Sleep Quality Index were consistently

lower for the morphine group, while the relative change from baseline

on the same index was significantly better at month 1, according to

Dr. Ghalie.

Patients in the two groups reported similar incidence and severity of

adverse effects.

Dr. Ghalie said both drugs clearly work well, but one reason for

differences in outcomes between the groups is that about a third of

patients typically need three times daily dosing for oxycodone rather

than the twice daily dosing indicated on the label.