The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding), and by imprecise results (wide confidence intervals).
A Cochrane review included 23 studies with a total of 2 648 subjects. The studies assessed the effectiveness and tolerability of oxycodone by any route of administration for pain in adults with cancer.
The ability of controlled-release (CR) and immediate-release (IR) oxycodone to provide pain relief were similar (SMD 0.1, 95% CI -0.06 to 0.26; 3 studies, n=578). Pooled analyses of adverse events showed no significant differences between CR and IR oxycodone for asthenia, confusion, constipation, dizziness/lightheadedness, drowsiness/somnolence, dry mouth, insomnia, nausea, nervousness, pruritus, vomiting, and discontinuation due to adverse events.
Pain relief was significantly better after treatment with CR morphine than CR oxycodone (SMD 0.14, 95% CI 0.01 to 0.27; 7 studies, n=882). However, sensitivity analysis did not corroborate this result (SMD 0.12, 95% CI -0.02 to 0.26). Pooled analyses of adverse events showed no significant differences between CR oxycodone and CR morphine for confusion, constipation, dizziness/lightheadedness, drowsiness/somnolence, dry mouth, dysuria, nausea, pruritus, vomiting, and discontinuation due to adverse events. However, the RR for hallucinations was significantly lower after treatment with CR oxycodone compared to CR morphine (RR 0.52, 95% CI 0.28 to 0.97; 4 studies, n=696).
The remaining studies either compared oxycodone in various formulations or compared oxycodone to different alternative opioids. None found any clear superiority or inferiority of oxycodone for cancer pain, neither as an analgesic agent nor in terms of adverse event rates and treatment acceptability.
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