Continued (oxycodone)

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During the long-term phase of the study, the dosage of CR oxycodone became constant at approximately 40 mg per day by week 16, while analgesia was maintained. A higher percentage of patients required downward titration as the trial progressed. Pain was controlled below a "moderate" level throughout the long-term trial with no significant trends from week 2 to the end of the trial. Withdrawal syndrome was not reported as an adverse event during scheduled respites, indicating that CR oxycodone at dosages less than 60 mg per day can be discontinued without tapering the dosage, if necessary. The use of CR oxycodone did not lead to a deterioration or an improvement in daily activities over the long course of therapy.

The authors conclude that patients with moderate to severe pain from osteoarthritis can achieve effective pain relief without deterioration in function when opioids are included as part of a comprehensive pain management program.

BARBARA APGAR, M.D., M.S.

Roth SH, et al. Around-the-clock, controlled-release oxycodone therapy for

osteoarthritis-related pain. Placebo-controlled trial and long-term

evaluation. Arch Intern Med March 27, 2000;160:853-60.

EDITOR'S NOTE: One of the significant results from this study was the finding that patients treated with sustained dosages of opioids were not impaired during their daily activities. In addition to the reduction in daily pain intensity, the patients were able to obtain better sleep with fewer night awakenings. Even adverse events such as nausea, pruritus, somnolence and constipation decreased as the study progressed. During the long-term phase, there were no clinically significant safety concerns, even among the patients who experienced somnolence. Safe relief of pain that affects enjoyment of life events should be a high priority for our patients.--b.a.

COPYRIGHT 2000 American Academy of Family Physicians

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