New study on morphine treatment in people with COPD and severe, long term breathlessness
en-GBde-DEes-ESfr-FR

New study on morphine treatment in people with COPD and severe, long term breathlessness

23/11/2022 Lund University

Sometimes healthcare professionals treat patients with opioids such as morphine to relieve symptoms, but there has been a lack of evidence as to whether this helps with severe chronic breathlessness. A randomised Phase 3 study conducted by Swedish and Australian researchers now finds that morphine does not reduce worst breathlessness.

The study is published in JAMA.

Long term shortness of breath is a common cause of ongoing suffering that often occurs with advanced serious illness and at the end of life.COPD can cause breathlessness bydamaging the lungs and airwaysand for seriously ill people with severe long term breathlessness, physical activity is often a challenge.

"Many people live with shortness of breath. It is distressing that no better treatment exists, but based on the results we’ve seen, we cannot generally recommend giving morphine to people with chronic breathlessness", says Magnus Ekström, a researcher in Palliative Medicine and Pulmonary Medicine at Lund University in Sweden and Chief Physician in Pulmonary Medicine at Blekinge Hospital.

The researchers included 156 patients, each for three weeks, with chronic obstructive pulmonary disease (COPD) who suffered from severe long term breathlessness. In the first week, the participants were randomised into three groups, two to regular low doses of once daily morphine (8 milligrams daily or 16 milligrams daily), and a third control group that received a placebo.

During the subsequent two weeks, participants were randomized to receive either an additional 8 milligrams of morphine or placebo, in addition to the previous treatment. This was done to investigate the efficacy of the treatment and the risk of side effects resulting from an increased dose of morphine. The treatment was ‘double-blind’, which means the participants and those who treated them didn’t know what treatment each group was receiving.

"Given the prevalence of long term breathlessness across the world, it is crucial that we find ways that safely and predictably reduce the suffering that this causes people, often for years", says David Currow, a palliative medicine physician at the University of Wollongong in Australia whose team worked on the study as a part of a national program to improve symptom control of people with advanced, life-limiting illnesses.

The researchers then compared the groups to see how they rated their experience of shortness of breath. With the help of motion sensors, the researchers also measured the participants’ physical activity during the study.

"Some probably expected that the study would show that regular, low dose morphine may allow people to be more physically active. Unfortunately, across all participants, we did not see this. We didn’t see any improvements in terms of theworst breathlessnessthat participants experienced", says Magnus Ekström.

According to Ekström, the use of regular low dose morphine for severe long term breathlessness should not be widely used in healthcare as a treatment for groups that experience chronic, activity-limiting shortness of breath.

However, the study should not be interpreted as that morphine does not provide any relief to patients with severe shortness of breath at rest, or in palliative care at the end of life. We didn’t investigate that in the study. In most cases, our patients did not have shortness of breath at rest. Clinical experience shows that at the end of life and in crisis situations, morphine treatment can help", says Magnus Ekström.

The next step will be to investigate in greater detail whether certain groups respond better to morphine, as well as which ones are at a higher risk of experiencing side effects.
Effect of Regular, Low-Dose, Extended-release Morphine on Chronic Breathlessness in Chronic Obstructive Pulmonary Disease
JAMA
doi:10.1001/jama.2022.20206
23/11/2022 Lund University
Regions: Europe, Sweden, Oceania, Australia
Keywords: Health, Medical

Testimonials

For well over a decade, in my capacity as a researcher, broadcaster, and producer, I have relied heavily on Alphagalileo.
All of my work trips have been planned around stories that I've found on this site.
The under embargo section allows us to plan ahead and the news releases enable us to find key experts.
Going through the tailored daily updates is the best way to start the day. It's such a critical service for me and many of my colleagues.
Koula Bouloukos, Senior manager, Editorial & Production Underknown
We have used AlphaGalileo since its foundation but frankly we need it more than ever now to ensure our research news is heard across Europe, Asia and North America. As one of the UK’s leading research universities we want to continue to work with other outstanding researchers in Europe. AlphaGalileo helps us to continue to bring our research story to them and the rest of the world.
Peter Dunn, Director of Press and Media Relations at the University of Warwick
AlphaGalileo has helped us more than double our reach at SciDev.Net. The service has enabled our journalists around the world to reach the mainstream media with articles about the impact of science on people in low- and middle-income countries, leading to big increases in the number of SciDev.Net articles that have been republished.
Ben Deighton, SciDevNet

We Work Closely With...


  • BBC
  • The Times
  • National Geographic
  • The University of Edinburgh
  • University of Cambridge
Copyright 2022 by AlphaGalileo Terms Of Use Privacy Statement