|R. N. Jamison, PhD, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass, compared naproxen (NP), oxycodone (OX) alone, and oxycodone plus controlled-release morphine (OXM) in 36 LBP patients. After four months' treatment, OXM patients reported less pain and emotional distress than the others. Overall, drug-related side effects occurred least frequently with NP dosing. Surprisingly, no differences were found on reported levels of activity among groups.|
|Pre-Study Demography||The study included 36 LBP patients resistant to traditional pain medicines. After dropping opioid use, the pain scores ranged from 4 to 10 (mean, 6.8) on a scale of 0 to 10. Pain duration averaged 79.4 months (range, 9 to 312 months). Mean age was 42.6 years and ranged from 30 to 60 years. There were more females (57.1%) than males. About one-half of the patients received disability benefits and nearly one-fifth were employed.|
A one-month washout period preceded random assignment to one of
three treatment groups:
Each LBP patient followed his/her assigned medication schedule for four months.
Weekly telephone calls to each patient yielded information on:
LBP severity, activity, mood, medication use, hours awake and
adverse events. Efficacy highlights included:
As seen above, there were significant treatment differences in average pain, anxiety, depression, and irritability but not in daily activity or hours awake.
|Safety||Weekly reported side effects totalled 812 over the four months. The NP group showed the fewest (190 or 23%), followed by OX- treated patients (309 or 38%) and OXM-medicated (313 or 39%). The most frequently reported side effects (dry mouth, drowsiness, headache, constipation, and nausea) occurred significantly less often in nonopioid (NP) patients. Because of the small number (11-13) of patients per treatment group, caution should be used in evaluating the efficacy and safety differences reported in this study.|
For professional correspondence, please contact Dr. Jamison at: firstname.lastname@example.org
Presented at American Pain Society Meeting on 15 Nov 1996
CONRAD NOTES, © November 1996 All Rights Reserved
Eugene A. Conrad, PhD, MPH / ISSN 1078 / posted 26-Dec-1996