title: One evidence base; three stories: do opioids relieve chronic breathlessness?
abstract: The efficacy of low-dose systemic opioids for chronic breathlessness was questioned by the recent Cochrane review by Barneset alWe examined the reasons for this conflicting finding and re-evaluated the efficacy of systemic opioids. Compared with previous meta-analyses, Barneset alreported a smaller effect and lower precision, but did not account for matched data of crossover trials (11/12 included trials) and added a risk-of-bias criterion (sample size). When re-analysed to account for crossover data, opioids decreased breathlessness (standardised mean differences -0.32; -0.18 to -0.47; I2=44.8%) representing a clinically meaningful reduction of 0.8 points (0-10 numerical rating scale), consistent across meta-analyses.
authors.affiliation: Division of Respiratory Medicine & Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Ekström
authors.affiliation: Cicely Saunders Institute, King's College London, London, UK.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Bajwah
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: J Martin
authors.initials: JM
authors.lastname: Bland
authors.affiliation: Discipline, Palliative and Supportive Services, Flinders University, Adelaide, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
authors.affiliation: Hull York Medical School, University of Hull, Hull, UK.
authors.forename: Jamilla
authors.initials: J
authors.lastname: Hussain
authors.affiliation: Hull York Medical School, University of Hull, Hull, UK.
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Johnson
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002908:Chronic Disease; D004417:Dyspnea / Q000517:prevention & control*; D006801:Humans
chemical_list: D000701:Analgesics, Opioid
keywords: COPD Pharmacology; Palliative Care; Perception of Asthma/Breathlessness