Abernethy [14] | Placebo-controlled randomised crossover trial (80% power) Intervention: 4 days oral morphine (sustained release) | 48 | COPD (88%) Cancer (6%) Other (6%) | ECOG status | VAS intensity | Better scores in the morphine arm Morning: 6.6 mm (95% CI 1.6–11.6 mm; p = 0.011); evening: 9.5 mm (3.0–16.1 mm; p = 0.006) |
Currow [24] | Dose-increment and pharmacovigilance study Intervention: oral morphine, dose titrated after 7 days if no response | 83 | COPD (54%) Cancer (29%) RLD (12%) Other (5%) | Australian modified Karnofsky scale | VAS intensity | Response rate (improvement of >10% over baseline) 52 (63%) out of 83; NNT = 1.6; NNH = 4.6 |
Johnson [17] | Pilot placebo-controlled randomised crossover trial Intervention: 4 days oral morphine | 10 | CHF | NYHA class | VAS intensity | Morphine arm: 23-mm reduction by day 2 (p = 0.02), sustained for duration of dosing Placebo arm: 13-mm reduction by day 2 (ns), reverted to baseline by day 4 |
Oxberry [16] | Placebo-controlled randomised crossover trial (80% power) Intervention: 4 days oral morphine or 4 days oxycodone | 37 | CHF | NYHA class and KPS | NRS intensity | ns difference between opioid and placebo or between the two types of opioid: -1.37 for placebo group versus -0.41 for morphine group (p = 0.13) and -1.29 for oxycodone group (p = 0.90) |