Abstract
IntroductionMorphine may decrease the intensity of chronic breathlessness but data from a large randomised controlled trial (RCT) are lacking. This first, large, parallel-group trial aimed to test the efficacy and...
Highlights
Morphine may decrease the intensity of chronic breathlessness but data from a large randomised controlled trial (RCT) are lacking
The primary aim of the present study was to determine the efficacy and safety of regular, low-dose, once daily, oral SR morphine compared with placebo for chronic breathlessness over 1 week in patients with severe disease
Two changes were made: (1) modified Medical Research Council (mMRC) eligibility criterion was changed from ≥3 to ≥2 and (2) the oxycodone randomisation group was deleted from the protocol and participants randomised to the morphine and placebo groups were retained in the present study
Summary
Morphine may decrease the intensity of chronic breathlessness but data from a large randomised controlled trial (RCT) are lacking. Adults with chronic breathlessness (modified Medical Research Council≥2) were randomised to 20 mg daily oral SR morphine and laxative (intervention) or placebo and placebo laxative (control) for 7 days. Until 2019, there had been no registered pharmacological treatment for the symptomatic reduction of chronic breathlessness.[5 12] Two meta-analyses of mostly small, crossover trials reported promising results for regular, low-dose, systemic opioids.[13,14,15] Most evidence pertains to patients with COPD and the use of oral sustained-release (SR) morphine.[15] A pooled analysis found that people with more severe breathlessness were more likely to benefit from morphine.[16]
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