A multi-investigator clinical evaluation of oral controlled-release morphine (MS Contin tablets) administered to...

The analgesic efficacy of oral controlled-release morphine (MS Contin Tablets; MSC) and its influence on quality of life, including parameters of nighttime sleep and daytime functioning, were evaluated in this open-label, sequential study in cancer patients. Seventy patients completed this multi-investigator study; each patient was assigned to one of two dosing protocols, as determined by their previous analgesic regimen. Evaluations were made at baseline (when patients were receiving their previous analgesic regimen) and again on the second visit, after a dosage level of MSC sufficient to control pain was reached for a minimum of two weeks. There were no significant (p greater than 0.17) differences in incidence of nausea, vomiting, or drowsiness experienced by patients during treatment with MSC and during previous analgesic regimens. A senna and docusate sodium preparation (Senokot-S Tablets; SKS) was used to alleviate opioid-induced constipation; consequently there was a significantly lower (p = 0.02) incidence of constipation during treatment with MSC. A moderate relationship between opioid dose and laxative consumption was observed. Pain intensity was significantly (p = 0.0001) decreased, and quality of nighttime sleep and daytime functioning were significantly (p = 0.0001) increased compared with baseline values. Patients' overall quality of life improved significantly (p = 0.0001) during treatment with MSC when compared to their previous analgesic regimens. In conclusion, the therapeutic merits afforded by MSC coupled with proper dose titration were perceived by the patients to be superior to those provided by their previous medications. The benefits of less frequent dosing combined with potent analgesic effect plus the aggressive use of laxatives resulted in a global improvement in quality of life for the patients involved in this study.