Is oxycodone efficacy reflected in serum concentrations? A multicenter, cross-sectional study in 456 adult cancer patients

Trine Naalsund Andreassen, Pl Klepstad, Andrew Davies, Kristin Bjordal, Staffan Lundström, Stein Kaasa, Ola Dale

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Context: The relationship between oxycodone and metabolite serum concentrations and clinical effects has not previously been investigated in cancer pain patients. Objectives: The aim of this study was to assess whether there is a relationship between oxycodone concentrations and pain intensity, cognitive functioning, nausea, or tiredness in cancer patients. Also, oxymorphone and noroxymorphone contributions to analgesia and the adverse effects of oxycodone were assessed. Methods: Four hundred fifty-six cancer patients receiving oxycodone for cancer pain were included. Pain was assessed using the Brief Pain Inventory. The European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30 was used to assess the symptoms of tiredness, nausea, constipation, and depression. Cognitive function was assessed using the Mini-Mental State Examination. Associations were examined by multiple linear or ordinal logistic regressions. Whether patients classified as being a "treatment success" or a "treatment failure" had different serum concentrations of oxycodone or metabolites was assessed using Mann-Whitney U-tests. Results: Serum concentrations of oxycodone and metabolites were not associated with pain intensity, nausea, tiredness, or cognitive function, with the exception that increased pain intensity was associated with higher oxymorphone concentrations. Patients with poor pain control and side effects had higher serum concentrations of the oxycodone metabolites, noroxycodone and noroxymorphone, compared with those with good pain relief and without side effects. Conclusion: This study of patients receiving oxycodone for cancer pain confirms previous observations that there is most likely no association between serum concentrations of opioid analgesics and clinical effects.

Original languageEnglish (US)
Pages (from-to)694-705
Number of pages12
JournalJournal of pain and symptom management
Volume43
Issue number4
DOIs
StatePublished - Apr 1 2012

Fingerprint

Oxycodone
Cross-Sectional Studies
Pain
Serum
Neoplasms
Oxymorphone
Nausea
Cognition
Constipation
Nonparametric Statistics
Treatment Failure
Analgesia
Opioid Analgesics
Logistic Models
Quality of Life
Depression
Equipment and Supplies

Keywords

  • Oxycodone
  • adverse effects
  • cancer pain cohort
  • effect
  • metabolites
  • treatment failure

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Is oxycodone efficacy reflected in serum concentrations? A multicenter, cross-sectional study in 456 adult cancer patients. / Andreassen, Trine Naalsund; Klepstad, Pl; Davies, Andrew; Bjordal, Kristin; Lundström, Staffan; Kaasa, Stein; Dale, Ola.

In: Journal of pain and symptom management, Vol. 43, No. 4, 01.04.2012, p. 694-705.

Research output: Contribution to journalArticle

Andreassen, Trine Naalsund ; Klepstad, Pl ; Davies, Andrew ; Bjordal, Kristin ; Lundström, Staffan ; Kaasa, Stein ; Dale, Ola. / Is oxycodone efficacy reflected in serum concentrations? A multicenter, cross-sectional study in 456 adult cancer patients. In: Journal of pain and symptom management. 2012 ; Vol. 43, No. 4. pp. 694-705.
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