Once-Daily Hydromorphone ER Effective in Chronic Neuropathic Pain

LAS VEGAS, NV—Patients with chronic neuropathic pain can be safely and effectively converted and maintained on hydromorphone extended-release (ER), as shown in an open-label study presented at PAINWeek 2012.

Hydromorphone ER is an opioid formulation administered once daily as around-the-clock medication to control moderate-to-severe chronic pain in opioid-tolerant patients. Srinivas Nalamachu, MD, from International Clinical Research Institute, Overland Park, KS, and colleagues conducted a single-center, open-label, 12-week study examining the efficacy and safety of once-daily hydromorphone ER in patients with chronic neuropathic pain. A total of 30 opioid-tolerant patients were converted from their previous opioid (mean daily morphine equivalent dose: 163.7mg) and titrated to adequate analgesia with hydromorphone ER over 2 weeks.

The primary efficacy measure was change from baseline on “average pain” on the Brief Pain Inventory (BPI) scale assessed at Week 12. Results from the Pain Quality Assessment Scale (PQAS) and the Global Assessment of Treatment Satisfaction (GATS) were included as secondary endpoints.

Patients received >1 dose of hydromorphone ER. They were initially converted to a mean daily dose of 18.1mg and subsequently titrated to a mean daily dose of 26.4mg. BPI "average pain" decreased from 5.9 at baseline to 4.5 at Week 12. The PQAS decreased significantly, from 104 at baseline to 79 at Week 12. Furthermore, no serious adverse events were reported.

The majority of patients (73%) were either very satisfied or satisfied with their treatment, reported Dr. Nalamachu and colleagues, who concluded that additional placebo-controlled studies are needed in this patient population in examining the safety and efficacy of once-daily hydromorphone ER.