PAIN+ CPN

In people with cancer, strong opioid painkillers do not differ from each other for pain relief or side effects

Schmidt-Hansen M, Bennett MI, Arnold S, et al. Oxycodone for cancer-related pain. Cochrane Database Syst Rev. 2015;2:CD003870.​​​​​​​

Review questions

In people with cancer, does oxycodone reduce pain better than other strong painkillers?

Background

People with cancer often have pain. Opioids, including oxycodone, are strong painkillers that are often prescribed for cancer pain. Oxycodone can be taken by mouth as immediate-release tablets or liquid (taken every 4 hours) or as controlled-release tablets (taken every 12-hours). Opioids do not reduce pain for all people, and they can have side effects.

How the review was done


The researchers did a systematic review, searching for published studies up to March 2014. They found 7 randomized controlled trials of 1390 people (average age 45 to 69 years).

People in the trials were 18 years of age or older and had pain related to cancer.

Oxycodone was compared with another dose or form of oxycodone, another active drug, or placebo.

What the researchers found


The quality of the evidence was low.

Controlled-release oxycodone and immediate-release oxycodone did not differ for pain relief in 3 of 3 trials or side effects in 3 of 4 trials.

Oxycodone and morphine did not differ for pain relief or side effects.

Other formulations of oxycodone and other opioids also did not differ for relief of pain or side effects.

Conclusions

In people with cancer, oxycodone does not differ from other strong opioids, including morphine, for relief of pain or side effects.

Oxycodone vs another dose or form of oxycodone or another active drug in people with cancer-related pain

Treatment comparisonNumber of trials (number of people)Effect of treatment
Controlled-release vs immediate- release oxycodone3 trials (578 people)No difference in pain or side effects
Oxycodone vs morphine5 trials (462 people)No difference in pain or side effects

This Evidence Summary was originally prepared for the McMaster Optimal Aging Portal.

Published: Monday, August 14, 2017