Oxycodone for cancer-related pain

Area of Science:

• Oncology
• Pain Management
• Pharmacology

Background:

• Cancer pain often requires strong opioids like oxycodone and morphine.
• These opioids are not universally effective or well-tolerated.
• This review updates previous findings on oxycodone for cancer pain.

Purpose of the Study:

• To assess the effectiveness and tolerability of oxycodone compared to other analgesics for adult cancer pain.
• To evaluate oxycodone's efficacy and safety across various administration routes.

Main Methods:

• Conducted an updated Cochrane review including randomized controlled trials.
• Searched multiple databases up to November 2021 without restrictions.
• Included studies comparing oxycodone to placebo or active drugs for cancer pain, analyzing pain intensity, relief, adverse events, and quality of life.

Main Results:

• 42 studies with 4485 participants were included.
• Controlled-release (CR) oxycodone showed little difference in pain intensity or relief versus immediate-release (IR) oxycodone.
• CR oxycodone demonstrated similar pain intensity and relief compared to CR morphine, with some evidence suggesting lower constipation rates but higher uncertainty for other adverse events.

Conclusions:

• Low-certainty evidence indicates minimal differences in pain relief and adverse events between oxycodone and other strong opioids like morphine.
• While CR morphine showed a slight, non-clinically significant pain relief benefit, CR oxycodone may have lower constipation rates.
• Oxycodone and morphine are both appropriate first-line oral opioids for managing adult cancer pain.