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The MERITO Study: a multicentre trial of the analgesic effect and tolerability of normal-release oral morphine during 'titration phase' in patients with cancer pain.
Palliat Med. 2008 Apr; 22(3):214-21.PM

Abstract

Adequate and rapid pain control is one of the main goals of cancer pain treatment. The objective of this study was to assess the effect and tolerability of oral normal-release morphine during the initial phase of treatment in patients with moderate-to-severe cancer pain. Consecutive patients naïve to strong opioids received normal-release morphine 5 or 10 mg every 4 h during the titration phase (first 5 days), depending on previous analgesic therapy. Pain intensity was assessed using an 11-point Numerical Rating Scale (0-10), and data were recorded in a patient-compiled diary. The primary endpoint was the proportion of time with pain control (a reduction of at least 50% with respect to the baseline pain score) during the titration phase. A total of 159 consecutive patients (102 men; mean age 65 years) with cancer-related pain were enrolled. Pain control was observed for 75% (95% CI 70-80) of the follow-up period in the intent-to-treat population. Overall, 50% and 75% of patients achieved pain control within 8 and 24 h after starting normal-release morphine therapy respectively. The mean pain score was 7.63 points at baseline, and decreased to 2.43 and 1.67 points (both P<0.001) at days 3 and 5 respectively. The most commonly reported adverse events were somnolence (24% of patients), constipation (22%), vomiting (13%), nausea (10%) and confusion (7%). Normal-release morphine results in rapid and satisfactory pain control, and is well tolerated, during the strong-opioid titration phase in patients with moderate-to-severe cancer pain.

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Authors+Show Affiliations

De Conno F
Rehabilitation and Palliative Care Operative Unit, IRCCS Foundation, National Cancer Institute, Milano, Italy.
Ripamonti C
No affiliation info available
Fagnoni E
No affiliation info available
Brunelli C
No affiliation info available
Luzzani M
No affiliation info available
Maltoni M
No affiliation info available
Arcuri E
No affiliation info available
Bertetto O
No affiliation info available
MERITO Study Group
No affiliation info available

MeSH

Administration, OralAdolescentAdultAgedAnalgesics, OpioidFemaleHumansMaleMiddle AgedMorphineNeoplasmsPain

Pub Type(s)

Clinical Trial, Phase IV
Journal Article
Multicenter Study

Language

eng

PubMed ID

18477715

Citation

De Conno, F, et al. "The MERITO Study: a Multicentre Trial of the Analgesic Effect and Tolerability of Normal-release Oral Morphine During 'titration Phase' in Patients With Cancer Pain." Palliative Medicine, vol. 22, no. 3, 2008, pp. 214-21.
De Conno F, Ripamonti C, Fagnoni E, et al. The MERITO Study: a multicentre trial of the analgesic effect and tolerability of normal-release oral morphine during 'titration phase' in patients with cancer pain. Palliat Med. 2008;22(3):214-21.
De Conno, F., Ripamonti, C., Fagnoni, E., Brunelli, C., Luzzani, M., Maltoni, M., Arcuri, E., & Bertetto, O. (2008). The MERITO Study: a multicentre trial of the analgesic effect and tolerability of normal-release oral morphine during 'titration phase' in patients with cancer pain. Palliative Medicine, 22(3), 214-21. https://doi.org/10.1177/0269216308088692
De Conno F, et al. The MERITO Study: a Multicentre Trial of the Analgesic Effect and Tolerability of Normal-release Oral Morphine During 'titration Phase' in Patients With Cancer Pain. Palliat Med. 2008;22(3):214-21. PubMed PMID: 18477715.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The MERITO Study: a multicentre trial of the analgesic effect and tolerability of normal-release oral morphine during 'titration phase' in patients with cancer pain. AU - De Conno,F, AU - Ripamonti,C, AU - Fagnoni,E, AU - Brunelli,C, AU - Luzzani,M, AU - Maltoni,M, AU - Arcuri,E, AU - Bertetto,O, AU - ,, PY - 2008/5/15/pubmed PY - 2008/12/17/medline PY - 2008/5/15/entrez SP - 214 EP - 21 JF - Palliative medicine JO - Palliat Med VL - 22 IS - 3 N2 - Adequate and rapid pain control is one of the main goals of cancer pain treatment. The objective of this study was to assess the effect and tolerability of oral normal-release morphine during the initial phase of treatment in patients with moderate-to-severe cancer pain. Consecutive patients naïve to strong opioids received normal-release morphine 5 or 10 mg every 4 h during the titration phase (first 5 days), depending on previous analgesic therapy. Pain intensity was assessed using an 11-point Numerical Rating Scale (0-10), and data were recorded in a patient-compiled diary. The primary endpoint was the proportion of time with pain control (a reduction of at least 50% with respect to the baseline pain score) during the titration phase. A total of 159 consecutive patients (102 men; mean age 65 years) with cancer-related pain were enrolled. Pain control was observed for 75% (95% CI 70-80) of the follow-up period in the intent-to-treat population. Overall, 50% and 75% of patients achieved pain control within 8 and 24 h after starting normal-release morphine therapy respectively. The mean pain score was 7.63 points at baseline, and decreased to 2.43 and 1.67 points (both P<0.001) at days 3 and 5 respectively. The most commonly reported adverse events were somnolence (24% of patients), constipation (22%), vomiting (13%), nausea (10%) and confusion (7%). Normal-release morphine results in rapid and satisfactory pain control, and is well tolerated, during the strong-opioid titration phase in patients with moderate-to-severe cancer pain. SN - 0269-2163 UR - https://www.unboundmedicine.com/medline/citation/18477715/The_MERITO_Study:_a_multicentre_trial_of_the_analgesic_effect_and_tolerability_of_normal_release_oral_morphine_during_'titration_phase'_in_patients_with_cancer_pain_ L2 - https://journals.sagepub.com/doi/10.1177/0269216308088692?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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