Low-dose extended-release morphine doesn’t relieve breathlessness in patients with COPD

Daily low-dose, extended-release morphine did not significantly reduce the intensity of worst breathlessness in people with chronic obstructive pulmonary disease (COPD) and severe chronic breathlessness, according to a study.

 In this double-blind, placebo-controlled randomized clinical trial, 160 people with COPD and chronic breathlessness were randomized 1:1:1 to receive 8 mg or 16 mg of oral extended-release morphine daily or placebo during week 1. At the start of weeks 2 and 3, people were randomized 1:1 to 8 mg of extended-release morphine daily, which was added to the prior week’s dose, or placebo.

Overall, 156 patients were included in the primary analyses and 138 patients completed treatment at week 1.

There was no significant difference in change in the intensity of worst breathlessness at week 1 between the 8 mg/d of morphine group and the placebo group or between the 16 mg/d of morphine group and the placebo group.

There was no significant difference between the 8 mg/d of morphine group and the placebo group, between the 16 mg/d of morphine group and the placebo, between the 24 mg/d of morphine group and the placebo group, or between the 32 mg/d of morphine group and the placebo group in mean daily step count at week 3.

Reference
Ekström M, Ferreira D, Chang S, et al. Effect of Regular, Low-Dose, Extended-release Morphine on Chronic Breathlessness in Chronic Obstructive Pulmonary Disease: The BEAMS Randomized Clinical Trial. JAMA. 2022;328(20):2022–2032. doi:10.1001/jama.2022.20206