Opioids in people with cancer-related pain.
BACKGROUND
Up to 80% of people with cancer experience pain at some time during their illness, and most will need opioid analgesics. This review assesses how different opioid analgesics compare, in terms of both pain control and adverse effects, in people with cancer.


METHODS
We conducted a systematic review and aimed to answer the following clinical question: what are the effects of opioids in treating cancer-related pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 22 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: codeine, dihydrocodeine, transdermal fentanyl, hydromorphone, methadone, morphine, oxycodone, and tramadol.
Quigley
Columba
C
Hammersmith Hospital Trust, London, UK.
D000284:Administration, Oral; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid; D003061:Codeine / Q000627:therapeutic use; D005283:Fentanyl; D006801:Humans; D008691:Methadone; D009369:Neoplasms / Q000139:chemically induced; D010098:Oxycodone / Q000627:therapeutic use; D010146:Pain / Q000139:chemically induced
D000700:Analgesics; D000701:Analgesics, Opioid; D010098:Oxycodone; D008691:Methadone; D005283:Fentanyl; D003061:Codeine