Low-dose inhaled methoxyflurane bests IV morphine for short-term relief of trauma-related pain

  • J Pain Res

  • Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Low-dose inhaled methoxyflurane offers greater and faster short-term pain relief than IV morphine in patients with severe trauma, with similar rates of adverse events (AEs).

Why this matters

  • Methoxyflurane offers emergency clinicians a nonopioid option for trauma-related pain.

Study design

  • A phase 3b, randomized, active-controlled, parallel-group, open-label study of 93 patients with moderate to severe trauma pain who were categorized into either a methoxyflurane (n=49) or standard analgesic treatment (SAT; IV morphine) group (n=44).
  • Funding: Mundipharma Pharmaceuticals srl.

Key results

  • Patients treated with methoxyflurane vs those treated with SAT showed:
    • Higher reduction in visual analogue scale (VAS; 0-10) pain intensity in the first 10 minutes (adjusted mean treatment difference, −5.54 mm; P=.029).
    • Higher proportion of VAS responders rate at 5 minutes (P=.021).
    • Shorter median time to onset of pain relief (9 vs 15 minutes).
    • Similar rates of nonserious adverse events (20.4% vs 4.8%).

Limitations

  • Study was not powered to determine noninferiority of methoxyflurane vs SAT.

Coauthored with Vijay Rathod, PhD.