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Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids

Open access
Moore, R Andrew, McQuay, Henry J·2005·Arthritis Research & Therapy

Abstract

Adverse events of opioids may restrict their use in non-cancer pain. Analysis of the incidence of common adverse events in trials conducted in non-cancer pain has usually been limited to opioids used to treat severe pain according to the WHO three-step ladder. To examine the incidence of common adverse events of opioids in non-cancer pain, a systematic review and meta-analysis of information from randomised trials of all opioids in non-cancer pain was undertaken. Studies used were published randomised trials of oral opioid in non-cancer pain, with placebo or active comparator. Thirty-four trials with 5,546 patients were included with 4,212 patients contributing some information on opioid adverse events. Most opioids used (accounting for 90% of patients) were for treating moderate rather than severe pain. Including trials without a placebo increased the amount of information available by 1.4 times. Because of clinical heterogeneity in condition, opioid, opioid dose, duration, and use of titration, only broad results could be calculated. Use of any oral opioid produced higher rates of adverse events than did placebo. Dry mouth (affecting 25% of patients), nausea (21%), and constipation (15%) were the most common adverse events. A substantial proportion of patients on opioids (22%) withdrew because of adverse events. Because most trials were short, less than four weeks, and because few titrated the dose, these results have limited applicability to longer-term use of opioids in clinical practice. Suggestions for improved studies are made.

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Crossref · 10.1186/ar1782

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Metadata

Authors
Moore, R. A., & McQuay, H. J.
Venue
Arthritis Research & Therapy
Published
2005-06-28
Volume
7
Issue
5
Pages
R1046-51
ISSN
1478-6354 (ISSN-L)
OpenAlex
W2110791210
Cited by
377
References
19
FWCI
2.01
Type
journal article
Language
en
Open access
gold

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CoChat. (2026). Citation check: Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. https://app.cochat.ai/papers/10.1186/ar1782
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Moore, R. A., & McQuay, H. J. (2005). Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. Arthritis Research & Therapy. https://doi.org/10.1186/ar1782

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.