TY - JOUR T1 - Effect of morphine on breathlessness and exercise endurance in advanced COPD: a randomised crossover trial JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01235-2017 VL - 50 IS - 4 SP - 1701235 AU - Sara J. Abdallah AU - Courtney Wilkinson-Maitland AU - Nathalie Saad AU - Pei Zhi Li AU - Benjamin M. Smith AU - Jean Bourbeau AU - Dennis Jensen Y1 - 2017/10/01 UR - http://erj.ersjournals.com/content/50/4/1701235.abstract N2 - The objective of the present study was to evaluate the effect of morphine on exertional breathlessness and exercise endurance in advanced chronic obstructive pulmonary disease (COPD).In a randomised crossover trial, we compared the acute effect of immediate-release oral morphine versus placebo on physiological and perceptual responses during constant-load cardiopulmonary cycle exercise testing (CPET) in 20 adults with advanced COPD and chronic breathlessness syndrome.Compared with placebo, morphine reduced exertional breathlessness at isotime by 1.2±0.4 Borg units and increased exercise endurance time by 2.5±0.9 min (both p≤0.014). During exercise at isotime, morphine decreased ventilation by 1.3±0.5 L·min−1 and breathing frequency by 2.0±0.9 breaths·min−1 (both p≤0.041). Compared with placebo, morphine decreased exertional breathlessness at isotime by ≥1 Borg unit in 11 participants (responders) and by <1 Borg unit in nine participants (non-responders). Baseline participant characteristics, including pulmonary function and cardiorespiratory fitness, were similar between responders and non-responders. A higher percentage of responders versus non-responders stopped incremental CPET due to intolerable breathlessness: 82 versus 33% (p=0.028).Immediate-release oral morphine improved exertional breathlessness and exercise endurance in some, but not all, adults with advanced COPD. The locus of symptom-limitation on laboratory-based CPET may help to identify patients most likely to benefit from morphine.Immediate-release oral morphine decreased exertional breathlessness and improved exercise endurance in advanced COPD http://ow.ly/mrHQ30dS2qS ER -