Use of oxycodone controlled-release immediately after NSAIDs: a new approach to obtain good pain control.

Introduction: Opioids are recommended as appropriate therapy for the treatment of cancer pain and chronic non-malig - nant pain. Oxycodone is an alternative agent to its parent compound, morphine, and is available in a controlled-release (CR) formulation that al- lows convenient twice-daily dosing. The aim of this study was to evaluate the efficacy and toler - ability of oxycodone CR as first-line therapy in patients with chronic cancer or non-cancer pain that was not relieved by non-steroidal anti-in - flammatorydrugs(NSAIDs). Methods: This was a prospective, open-la - bel, multicentre trial carried out in 8 pain and oncology centres in Italy. Patients (n=309) with NSAID-refractory chronic cancer (55.7%), non- cancer (39.4%) or mixed (4.9%) pain (rating of 4- 10 on a numerical rating scale (NRS) from 0-10) were enrolled. Patients were treated with oral oxycodone CR twice daily for at least 28 days. Dosage was individualized for each patient and up-titrated over the first week of treatment. The primary endpoint was reduction in NRS score for pain. Secondary endpoints were tolerability, quality of life and patient assessment of treat - mentefficacy. Results: A significant decrease (57%) in pain intensity was recorded during the first week of therapy (decrease in NRS score from 7.85 ± 1.4 to 3.35 ± 1.8; p<0.00001). Overall, there was a 72.3% reduction in NRS pain score from base - line at the end of the study. Quality of life signifi- cantly ( p<0.005) improved during oxycodone therapy, and 91% of patients rated treatment as "effective" or "very effective". Five patients stopped oxycodone CR treatment because of adverse events, and one stopped treatment be - causeofdysphagia.