Randomized Trial of Low-Dose @entity1286 Versus Weak Opioids in Moderate XXXX .

@entity1 @entity5 @entity1337 @entity1286 @entity158
PURPOSE: The WHO guidelines on @entity5 management recommend a sequential three-step analgesic ladder. However, conclusive data are lacking as to whether moderate @entity158 should be treated with either step II weak opioids or low-dose step III strong opioids. @entity1 AND METHODS: In a multicenter, 28-day, open-label randomized controlled study, adults with moderate @entity5 were assigned to receive either a weak opioid or low-dose @entity1286 . The primary outcome was the number of responder @entity1 , defined as @entity1 with a 20% reduction in @entity158 intensity on the numerical rating scale. RESULTS: A total of 240 @entity1 with @entity5 (118 in the low-dose @entity1286 and 122 in the weak-opioid group) were included in the study. The primary outcome occurred in 88.2% of the low-dose @entity1286 and in 57.7% of the weak-opioid group (odds risk, 6.18; 95% CI, 3.12 to 12.24; P < .001). The percentage of responder @entity1 was higher in the low-dose @entity1286 group, as early as at 1 week. Clinically meaningful (>=  30%) and highly meaningful (>=  50%) @entity158 reduction from baseline was significantly higher in the low-dose @entity1286 group (P < .001). A change in the assigned treatment occurred more frequently in the weak-opioid group, because of inadequate @entity1337 . The general condition of @entity1 , which was based on the Edmonton Symptom Assessment System overall symptom score, was better in the @entity1286 group. Adverse effects were similar in both groups. CONCLUSION: In @entity1 with @entity5 and moderate @entity158 , low-dose @entity1286 reduced @entity158 intensity significantly compared with weak opioids, with a similarly good tolerability and an earlier effect.
