Lapin J, Houde R W, Kaiko R F, Coyle N, Rogers A, Foley K M
J Pain Symptom Manage. 1989 Sep;4(3):146-51. doi: 10.1016/0885-3924(89)90008-0.
An open-label pilot study was conducted to assess the efficacy and acceptability of a controlled-release oral morphine formulation, MS Contin tablets, when administered "by the clock" two to three times daily as a substitute for opioids given on request to patients with pain caused by advanced cancer. Initially, four-hourly does of standard "immediate-release" oral morphine sulfate tablets were substituted for the patients' prior analgesic medication and titrated to individual needs. Forty of the 47 patients enrolled in the study were subsequently switched to an eight-hourly MS Contin regimen (three patients became too ill to continue the study, and four left the study during the immediate-release titration phase because of adverse reactions that may have been drug related). Small "rescue" doses of standard oral morphine were available to the patients, but they were taken infrequently. Twenty-one of the 37 patients maintained on the eight-hourly schedule consented to be treated with, and were subsequently stabilized on, MS Contin administered every 12 hr, with a reduction of over 20% in their average daily morphine dose. Most of the patients rated the controlled-release medication superior to the standard oral morphine tablets in terms of both convenience and adequacy of relief.
开展了一项开放标签的试点研究，以评估控释口服吗啡制剂美施康定片每日两到三次“按时”给药，替代按需给予晚期癌症疼痛患者阿片类药物的疗效和可接受性。最初，每四小时服用标准的“即释”硫酸吗啡口服片剂，替代患者先前的镇痛药物，并根据个体需求进行滴定。该研究纳入的47名患者中，有40名随后改用每八小时一次的美施康定给药方案（3名患者病情过重无法继续研究，4名患者在即释滴定阶段因可能与药物相关的不良反应退出研究）。患者可使用小剂量的标准口服吗啡作为“解救”用药，但使用频率不高。37名维持每八小时一次给药方案的患者中，有21名同意接受每12小时一次的美施康定治疗，随后病情稳定，平均每日吗啡剂量减少超过20%。大多数患者认为，就便利性和缓解效果而言，控释药物优于标准口服吗啡片。
