Woelken M, Poppinger J, Wolf M, Jaegel-Guedes E, Jaeger H; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 271 (abstract no. Th.B.4115).
KIS, Curatorium for Immunedeficiency, Munich, Germany. Fax: +49-89-55039.
Objective: To evaluate the effects of pain therapy with an oral retarded morphine preparation. Methods: A retrospective analysis of patients who received oral retarded morphine therapy was performed. Patients were included if they recieved oral morphines and if pain treatment was started between 1/4/94 and 30/4/95. Results: N=92 patients were included in this analysis. At time of morphine treatment 84% of the patients were at stage CDC 3C, 16% at stage CDC 2B. Mean CD4 cell count at start of therapy was 64/microliter (plus or minus 129). 78% of the patients had homo-/bisexual contacts as their risk factor of HIV infection; 13% i.v. drug use. 9% were patients with heterosexual transmission or unknown infection risk factors. 4% of the patients received methadone substitution treatment prior and during pain therapy. Visceral pain was most frequent with 35%, followed by neuropathic (33%), mucosal (17%), and skeletal (11%). 4% of the pain episodes were not classifiable. Mean treatment time with morphine was 86 (plus or minus 91) days. The patients received morphine in a retarded tablet form two times a day. Mean dosage at start of therapy was 58.8mg (plus or minus 42mg) per day. The required amount of morphine increased during therapy in 70% of the patients to a mean of 90.0mg (plus or minus 54mg) and decreased towards the end of the pain episodes to 7.0 mg (plus or minus 41mg) per day. In 76% of the patients oral morphine reduced pain to tolerable or unrecognizable levels, 24% of the patients reported an unsatisfactory reduction or an increase of pain. Neuropathic pain had the best response rate with 83%, followed by visceral pain (77%), mucosal and non-classifiable pain with 75% and skeletal pain with 50%. Differences are, however, statistically not significant. CD4 cell count at entry, methadone treatment, or risk factor of HIV infection did not predict a failure of pain therapy. Conclusions: In this small retrospective analysis oral retarded morphine produced good results in control of pain of various aetiology in advanced HIV disease, regardless of previous or concomitant use of other opiates. With dosages decreasing over time development of addition seems to be unlikely, due to the pharmacokinetic profile of the retarded release tablets.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Analgesia
- Analgesia, Epidural
- Analgesia, Patient-Controlled
- CD4 Lymphocyte Count
- Drug Therapy, Combination
- HIV Infections
- HIV Seropositivity
- Humans
- Morphine
- Pain
- Pain Clinics
- Pain Measurement
- Palliative Care
- Risk Factors
- drug therapy
- therapy
Other ID:
UI: 102220415
From Meeting Abstracts