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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.