Oral modified release morphine for breathlessness in chronic heart failure: a randomized placebo-controlled trial

ESC Heart Failure
Miriam J JohnsonAndrew L Clark

Abstract

Morphine is shown to relieve chronic breathlessness in chronic obstructive pulmonary disease. There are no definitive data in people with heart failure. We aimed to determine the effectiveness and cost-effectiveness of 12 weeks morphine therapy for the relief of chronic breathlessness in people with chronic heart failure compared with placebo. Parallel group, double-blind, randomized, placebo-controlled, phase III trial of 20 mg daily oral modified release morphine was conducted in 13 sites in England and Scotland: hospital/community cardiology or palliative care outpatients. The primary analysis compared between-group numerical rating scale average breathlessness/24 hours at week 4 using a covariance pattern linear mixed model. Secondary outcomes included treatment-emergent harms (worse or new). The trial closed early due to slow recruitment, randomizing 45 participants [average age 72 (range 39-89) years; 84% men; 98% New York Heart Association class III]. For the primary analysis, the adjusted mean difference was 0.26 (95% confidence interval, -0.86 to 1.37) in favour of placebo. All other breathlessness measures improved in both groups (week 4 change-from-baseline) but by more in those assigned to morphine. Neither group wa...Continue Reading

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Citations

Aug 3, 2020·Current Opinion in Supportive and Palliative Care·J Alberto Neder, Denis E O'Donnell
Aug 9, 2020·The European Respiratory Journal·Andreas von Leupoldt, Núria Farre
Jan 7, 2020·European Heart Journal·John G F ClelandJohn J V McMurray
Oct 31, 2020·Current Heart Failure Reports·James M BeattieTheresa A McDonagh
Apr 9, 2021·Peptides·Richard J Bodnar
Aug 12, 2021·SAGE Open Medical Case Reports·Tomohiro NakamuraShin-Ichi Momomura

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Clinical Trials Mentioned

ISRCTN41349358

Software Mentioned

HF
BreatheMOR

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