- In patients with advanced COPD, regular, low-dose, oral sustained-release morphine is associated with better outcomes than placebo and without serious respiratory adverse effects.
Why this matters
- This study provides the evidence base for morphine's current role in palliative treatment for chronic breathlessness.
- In this 4-week MORDYC trial, patients (N=111) were randomly assigned to receive to morphine (10 mg twice daily) or placebo, with the possibility of increasing the intervention to 3 times daily after 1 or 2 weeks.
- Primary outcomes were scores on the COPD Assessment Test (CAT; with higher scores indicating worse status) and arterial partial pressure of carbon dioxide (PaCO2).
- Funding: The Netherlands Organisation for Health Research and Development.
- The morphine group had better CAT scores (mean difference, 2.18 points lower than placebo; P=.03).
- The groups did not differ in PaCO2 (morphine group mean difference, 1.19 mm Hg higher than placebo; P=.55).
- With 1 exception, they also did not differ in breathlessness (P=.19).
- Exception: a subgroup with the worst breathlessness, which had modified Medical Research Council breathlessness grades 3-4.
- They had a mean difference of 1.33 points lower than the morphine group (P=.03).
- Low participation (only 27% agreed).
- No long-term follow-up.