Efficacy and safety of combined prolonged-release oxycodone and naloxone in the management of moderate/severe chronic non-malignant pain: results of a prospectively designed pooled analysis of two randomised, double-blind clinical trials

BMC Clin Pharmacol. 2010 Sep 29;10:12. doi: 10.1186/1472-6904-10-12.

Abstract

Background: Two randomised 12-week, double-blind, parallel-group, multicenter studies comparing oxycodone PR/naloxone PR and oxycodone PR alone on symptoms of opioid-induced bowel dysfunction in patients with moderate/severe non-malignant pain have been conducted.

Methods: These studies were prospectively designed to be pooled and the primary outcome measure of the pooled data analysis was to demonstrate non-inferiority in 12-week analgesic efficacy of oxycodone PR/naloxone PR versus oxycodone PR alone. Patients with opioid-induced constipation were switched to oxycodone PR and then randomised to fixed doses of oxycodone PR/naloxone PR (n = 292) or oxycodone PR (n = 295) for 12 weeks (20-80 mg/day).

Results: No statistically significant differences in analgesic efficacy were observed for the two treatments (p = 0.3197; non-inferiority p < 0.0001; 95% CI -0.07, 0.23) and there was no statistically significant difference in frequency of analgesic rescue medication use. Improvements in Bowel Function Index score were observed for oxycodone PR/naloxone PR by Week 1 and at every subsequent time point (-15.1; p < 0.0001; 95% CI -17.3, -13.0). AE incidence was similar for both groups (61.0% and 57.3% of patients with oxycodone PR/naloxone PR and oxycodone PR alone, respectively).

Conclusions: Results of this pooled analysis confirm that oxycodone PR/naloxone PR provides effective analgesia and suggest that oxycodone PR/naloxone PR improves bowel function without compromising analgesic efficacy.

Trial registration numbers: ClinicalTrials.gov identifier: NCT00412100 and NCT00412152.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / therapeutic use
  • Chronic Disease
  • Clinical Trials as Topic
  • Constipation / chemically induced*
  • Constipation / complications
  • Delayed-Action Preparations / administration & dosage
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Naloxone / administration & dosage
  • Naloxone / adverse effects
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / administration & dosage*
  • Oxycodone / administration & dosage
  • Oxycodone / adverse effects
  • Oxycodone / therapeutic use*
  • Pain / drug therapy*
  • Pain Measurement
  • Patient Discharge
  • Safety*
  • Treatment Outcome
  • Young Adult

Substances

  • Analgesics, Opioid
  • Delayed-Action Preparations
  • Narcotic Antagonists
  • Naloxone
  • Oxycodone

Associated data

  • ClinicalTrials.gov/NCT00412100
  • ClinicalTrials.gov/NCT00412152