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Titration with Oxymorphone Extended Release to Achieve Effective Long-Term Pain Relief and Improve Tolerability in Opioid-Naive Patients with Moderate to Severe Pain
Article first published online: 7 DEC 2007
DOI: 10.1111/j.1526-4637.2007.00390.x
© American Academy of Pain Medicine
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How to Cite
Rauck, R., Ma, T., Kerwin, R. and Ahdieh, H. (2008), Titration with Oxymorphone Extended Release to Achieve Effective Long-Term Pain Relief and Improve Tolerability in Opioid-Naive Patients with Moderate to Severe Pain. Pain Medicine, 9: 777–785. doi: 10.1111/j.1526-4637.2007.00390.x
Publication History
- Issue published online: 23 SEP 2008
- Article first published online: 7 DEC 2007
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Keywords:
- Chronic Pain;
- Extended Release;
- Long-Acting Opioid;
- Opioid;
- Opioid-Naive;
- Oxymorphone
ABSTRACT
Objective. Assess the effectiveness and tolerability of a program of gradual dose titration with oxymorphone extended release (ER) for treatment of moderate to severe chronic pain in opioid-naive patients.
Design. Open-label, nonrandomized 6-month study with a titration/stabilization period of ≤1 month followed by a 5-month maintenance period.
Setting. Multidisciplinary pain centers in the United States.
Patients. Adult opioid-naive patients with moderate to severe chronic pain.
Interventions. Patients were gradually titrated from a 5-mg dose of oxymorphone ER (taken every 12 hours) to a stabilized dose that provided effective pain relief and was well tolerated.
Outcome Measures. Brief Pain Inventory Short Form questions 5 and 9, patient and physician global assessments of pain relief, adverse events (AEs), and discontinuations.
Results. The majority (94/126; 75%) of patients were stabilized on a dose of oxymorphone ER that provided effective pain relief with tolerable AEs. Most (81/94; 86%) required <24 days to reach a stable dose. Sixteen percent of patients in the titration period and 17% of patients in the maintenance period discontinued because of AEs possibly or probably related to oxymorphone ER. Patients completing the entire 5-month maintenance period experienced effective pain relief with significant (>50%) reductions of pain interference with quality-of-life measures. There was minimal dose escalation over the 5 months and low use of rescue medication.
Conclusions. Oxymorphone ER provided effective pain relief from moderate to severe chronic pain in opioid-naive patients. Gradual titration was well tolerated, with a low rate of discontinuations caused by AEs.