Rescue factor: a design for evaluating long-acting analgesics

Clin Pharmacol Ther. 1988 Apr;43(4):376-80. doi: 10.1038/clpt.1988.46.

Abstract

A design is described that uses need for supplemental (rescue) analgesic as a factor predicting effectiveness of a test analgesic. This methodology is especially suited for evaluating long-acting analgesics given repeatedly. Rescue use is measured over dosing intervals as test drug is titrated from a subanalgesic dose to that requiring no or minimal rescue. This design was used to evaluate oral long-acting morphine sulfate (MS Contin) given every 12 hours in a crossover study of cancer pain using oral immediate-release morphine sulfate given every 4 hours as reference. Less morphine was required for MS Contin given every 12 hours relative to immediate-release morphine sulfate given every 4 hours (186 +/- 22 mg vs. 239 +/- 35 mg; p = 0.04). Total daily morphine for both regimens correlated linearly (r = 0.96) with a slope of 1.27 +/- 0.11, significantly (p = 0.03) different from equivalence (slope of unity) in favor of MS Contin. This design features assay sensitivity (dose-response) and provides relative potency estimates for analgesics given at specific regimens.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Delayed-Action Preparations
  • Drug Administration Schedule
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morphine / administration & dosage*
  • Pain / drug therapy*
  • Pain Measurement

Substances

  • Delayed-Action Preparations
  • Morphine