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This study is to evaluate the safety and tolerability of oxycodone control-released (CR) and/or immediate-released (IR) use in patients with moderate to severe cancer pain in a 3-months period in Taiwan.
This is an open label, long-term study carrying in multi-centers. Around 200 patients with moderate to severe cancer pain (NRS ≥ 4) who agreed and signed informed consent will be enrolled to receive oxycodone with continuous around-the-clock pattern. The study is to evaluate the safety and tolerability of cancer patients who receive CR and/or IR oxycodone. The number and percentage of patients with adverse events and serious adverse events will be recorded throughout the study.
The study will continue for 3 months to observe the safety and tolerability. After screening at Screening visit, patients begin the study by the first day visit (Day 1). Pain assessment, study related questionnaires are giving out to measure the baseline scale of each patient. Questionnaires including rate of quality of analgesia, EQ-5D and clinical opiate withdrawal scale (COWS). The prescription of the study drug will be recorded from Day 1. Patients will need to visit bi-weekly, including Wk 2 (Day 14±3), Wk 4 (Day 28±3), Wk 6 (Day 42±3), Wk 8 (Day 56±3), Wk 10 (Day 70±3) and Wk 12 (Day 84±3). Pain assessment will be assessed in each visit, drug accountability will be recorded accordingly. The rate of quality of Analgesia will be assessed in each visit; QoL (EQ-5D) will be recorded in Wk 4, Wk 8 and Wk 12. The COWS will be assessed again in Wk 12.
The safety for individual patient will be followed during study up to 2 weeks after the end of treatment (EOT) or early termination (ET). The telephone contact for safety follow-up is acceptable for this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Oxycodone treatment | Experimental | Patients will take either control-released oxycodone (OxyContin® 10mg and 20mg) or immediate-released oxycodone (OxyNorm® 5mg) or both for initial dose and used it to titrate his/her background dose. After regular time assessment of the pain score (NRS), if the pain control is inadequate (NRS ≥ 4), a total daily dose in 24hrs will be summed up for the next dose titration until reach a stable dose (as defined as total daily dose is fixed for at least two weeks). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Oxycodone | Drug | Patients will take either CR oxycodone or IR oxycodone or both for initial dose and used it to titrate his/her background dose. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number and percentage of patients with adverse events (AEs) and serious adverse events (SAEs) | Number and percentage of patients with adverse events (AEs) and serious adverse events (SAEs) | Up to 14 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline pain intensity scale (NRS) | The change from baseline pain intensity scale (NRS) to each visit | Up to 12 weeks |
| Time (days) needs in first titration to a stable dose | The time (days) needs in first stable titration |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Changhua Christian Hospital | Chang-hua | 500 | Taiwan | |||
| Chang Gung Memorial Hospital, Chiayi branch |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19244085 | Background | Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, Cohen R, Dow L. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009 Aug;20(8):1420-33. doi: 10.1093/annonc/mdp001. Epub 2009 Feb 24. | |
| 22300860 | Background | Caraceni A, Hanks G, Kaasa S, Bennett MI, Brunelli C, Cherny N, Dale O, De Conno F, Fallon M, Hanna M, Haugen DF, Juhl G, King S, Klepstad P, Laugsand EA, Maltoni M, Mercadante S, Nabal M, Pigni A, Radbruch L, Reid C, Sjogren P, Stone PC, Tassinari D, Zeppetella G; European Palliative Care Research Collaborative (EPCRC); European Association for Palliative Care (EAPC). Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012 Feb;13(2):e58-68. doi: 10.1016/S1470-2045(12)70040-2. |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D010146 | Pain |
| D000072716 | Cancer Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D010098 | Oxycodone |
| ID | Term |
|---|---|
| D003061 | Codeine |
| D009022 | Morphine Derivatives |
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
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| Up to 12 weeks |
| Average dosage (mg/day) needs in first titration to a stable dose | The average dosage needs in first stable titration | Up to 12 weeks |
| Quality of analgesia using rating of excellent, very good, good, fair or poor | The percentage of patients rating quality of analgesia of excellent, very good, good, fair or poor | Up to 12 weeks |
| Treatment discontinuation reason (due to AE, withdraw consent, or any kinds of reasons) | Analysis treatment discontinue reason (due to AE, withdraw consent, or any kinds of reasons) | Up to 12 weeks |
| Change from baseline in QoL questionnaire (EQ-5D) | The change from baseline in QoL questionnaire (EQ-5D) | Up to 12 weeks |
| Opiate withdrawal level by Clinical Opiate Withdrawal Scale (COWS) | The change of clinical opiate withdrawal scale (COWS) from baseline | Up to 12 weeks |
| Safety and tolerability (PE and vital sign change from baseline) | The change from baseline in PE and vital sign | Up to 14 weeks |
| Chiayi City |
| Taiwan |
| Chang Gung Memorial Hospital, Kaohsiung branch | Kaohsiung City | 83301 | Taiwan |
| Chang Gung Memorial Hospital, Keelung branch | Keelung | 204 | Taiwan |
| China Medical University Hospital | Taichung | 40447 | Taiwan |
| Taichung Veterans General Hospital | Taichung | Taiwan |
| MacKay Memorial Hospital | Taipei | 10449 | Taiwan |
| Shin Kong Wu Ho-Su Memorial Hospital | Taipei | 111 | Taiwan |
| Tri-Service General Hospital | Taipei | 114 | Taiwan |
| Chang Gung Memorial Hospital, LinKou branch | Taoyuan City | 333 | Taiwan |
| 25218610 | Background | Ahmedzai SH, Leppert W, Janecki M, Pakosz A, Lomax M, Duerr H, Hopp M. Long-term safety and efficacy of oxycodone/naloxone prolonged-release tablets in patients with moderate-to-severe chronic cancer pain. Support Care Cancer. 2015 Mar;23(3):823-30. doi: 10.1007/s00520-014-2435-5. Epub 2014 Sep 14. |
| 17488292 | Background | Panchal SJ, Muller-Schwefe P, Wurzelmann JI. Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden. Int J Clin Pract. 2007 Jul;61(7):1181-7. doi: 10.1111/j.1742-1241.2007.01415.x. Epub 2007 May 4. |
| 20714946 | Background | Mueller-Lissner S. Fixed combination of oxycodone with naloxone: a new way to prevent and treat opioid-induced constipation. Adv Ther. 2010 Sep;27(9):581-90. doi: 10.1007/s12325-010-0057-y. Epub 2010 Aug 11. |
| 9695203 | Background | Mancini I, Bruera E. Constipation in advanced cancer patients. Support Care Cancer. 1998 Jul;6(4):356-64. doi: 10.1007/s005200050177. |
| 15907646 | Background | Kalso E. Oxycodone. J Pain Symptom Manage. 2005 May;29(5 Suppl):S47-56. doi: 10.1016/j.jpainsymman.2005.01.010. |
| 20884999 | Background | Leppert W. Role of oxycodone and oxycodone/naloxone in cancer pain management. Pharmacol Rep. 2010 Jul-Aug;62(4):578-91. doi: 10.1016/s1734-1140(10)70316-9. |
| 25516773 | Background | Stessel B, Theunissen M, Fiddelers AA, Joosten EA, Kessels AG, Gramke HF, Marcus MA. Controlled-release oxycodone versus naproxen at home after ambulatory surgery: a randomized controlled trial. Curr Ther Res Clin Exp. 2014 Nov 28;76:120-5. doi: 10.1016/j.curtheres.2014.10.001. eCollection 2014 Dec. |
| 10534967 | Background | Salzman RT, Roberts MS, Wild J, Fabian C, Reder RF, Goldenheim PD. Can a controlled-release oral dose form of oxycodone be used as readily as an immediate-release form for the purpose of titrating to stable pain control? J Pain Symptom Manage. 1999 Oct;18(4):271-9. doi: 10.1016/s0885-3924(99)00079-2. |
| D000470 |
| Alkaloids |
| D006571 | Heterocyclic Compounds |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |