a patient preference study comparing two extended-release morphine sulfate formulations for cancer pain
from clinical drug investigation [tm]
robert o. kerr, southwest regional cancer center, austin, texas, usa; william j. tester, albert einstein cancer center, philadelphia, pennsylvania, usa
abstract and introduction
to compare pain control, patient preference and tolerability for two extended-release formulations of morphine sulfate, kadian®
capsules (administered once daily) and ms contin®
tablets (administered twice daily), in the treatment of chronic cancer pain.
patients and methods:
a randomised, open-label, multicentre, crossover study was conducted in 178 patients requiring treatment for cancer pain, of which 134 were included in the tolerability analysis and 114 took part in the efficacy analysis. primary efficacy measures yielded pain scores, which were analysed with repeated measures analysis of variance (anova), and patient preference was analysed with a goodness-of-fit chi2 test. secondary efficacy measurements and tolerability assessments were analysed using an anova model.
a total of 57 of 104 patients (55%) preferred treatment with kadian®
, 34 (33%) preferred treatment with ms contin®
, and 13 (12%) had no preference (p = 0.001). there were no clinically important, statistically significant differences between kadian®
and ms contin®
in pain assessments, rescue medication usage, investigator global assessments, health-related quality-of-life measures, morphine-related adverse effects, other adverse events, or dropout rates.
patient preference for kadian®
over ms contin®
may reflect benefits of once-daily versus
twice-daily administration, since both treatments provided comparable pain control and tolerability profiles.