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Morphine for dyspnoea in chronic obstructive pulmonary disease: a before-after efficacy study

Yoshinobu Matsuda¹, Tatsuya Morita², Hirotaka Matsumoto³

¹Department of Psychosomatic Internal Medicine, Kinki Chuo Chest Medical Center, Sakai, Japan matsuda.yoshinobu.tx@mail.hosp.go.jp.

BMJ Supportive & Palliative Care

|November 17, 2019

Summary

Oral morphine effectively reduced breathlessness in Japanese patients with chronic obstructive pulmonary disease (COPD). This study showed significant improvements in dyspnoea symptoms with minimal adverse events, offering a new treatment option.

Area of Science:

Pulmonary Medicine
Pharmacology

Background:

Dyspnoea is a common and persistent symptom in patients with chronic obstructive pulmonary disease (COPD).
Conventional treatments often fail to fully alleviate severe dyspnoea in COPD patients.

Purpose of the Study:

To evaluate the efficacy and safety of oral morphine for managing persistent dyspnoea in Japanese COPD patients.
To assess the impact of oral morphine on dyspnoea intensity and adverse events.

Main Methods:

A multi-institutional, prospective, before-after study involving 34 Japanese COPD patients with resting dyspnoea.
Patients received daily oral morphine (12 mg or 8 mg based on weight/renal function).
Dyspnoea intensity was measured using the Numerical Rating Scale (NRS) from Day 0 to Day 2.

Main Results:

Oral morphine significantly reduced evening dyspnoea intensity (NRS) from 3.9 to 2.4 (p=0.0002).
Secondary outcomes, including other measures of dyspnoea, also showed significant improvement.
Adverse events were generally mild, with no significant changes in vital signs or opioid-related side effects.

Conclusions:

Oral morphine is an effective and safe option for alleviating chronic dyspnoea in Japanese COPD patients.
The findings suggest that low-dose oral morphine can be a valuable therapeutic strategy for refractory dyspnoea in COPD.

Keywords:

clinical trials and COPD dyspnoea morphine

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