The Pain Pen for Breakthrough Cancer Pain
Information source: Erasmus Medical Center
Information obtained from ClinicalTrials.gov on August 08, 2008
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Neoplasms; Pain
Intervention: Subcutaneous hydromorphone delivered by pain pen (Drug)
Phase: Phase 3
Sponsored by: Erasmus Medical Center
Official(s) and/or principal investigator(s):
Joost L. Jongen, MD, Principal Investigator, Affiliation: Dept. Neurology, Erasmus MC
The purpose of this study is to see whether injection of hydromorphone through a subcutaneous
injection device is more effective in treating breakthrough cancer pain than oral morphine.
Official title: Breakthrough Cancer Pain: A Randomized Trial Comparing Oral Morphine Immediate Release and Self-Administration of Subcutaneous Hydromorphone Using an Injection Pen
Study design: Treatment, Randomized, Double-Blind, Active Control, Crossover Assignment, Efficacy Study
Primary outcome: Pain intensity difference (PID) at t=15 minutes
time to onset of meaningful pain relief
global efficacy rating at 60'
Breakthrough pain is an exacerbation of severe pain that occurs on a background of otherwise
controlled pain. Breakthrough pain is common in patients with advanced cancer. Current
medications to treat breakthrough pain include oral immediate release opioid formulations and
more recently oral transmucosal fentanyl citrate.
The pain pen study is a randomized controlled double blind cross-over study comparing the
efficacy of oral immediate release morphine with that of subcutaneous hydromorphone, injected
through a so called pain pen, on breakthrough pain in cancer patients. Preliminary experience
with the pain pen suggests that it has a more rapid time of onset of pain relief than oral
Minimum age: 18 Years.
Maximum age: N/A.
- Stable cancer pain requiring the equivalent of 60-1000 mg oral
- 1-4 breakthrough pain episodes/day
- Patients must be able, in the opinion of the investigator, to fully comply with trial
- Patients who have given written informed consent
- Uncontrolled pain
- Women who are pregnant, lactating or intend to become pregnant
- Cardiopulmonary disease that would increase the risk of opioids
- Neurologic or psychiatric disease that would compromise data collection
- Recently started chemotherapy or radiotherapy in as far as it would be effective in
lowering breakthrough pain
Locations and Contacts
Dept. Neurology, Erasmus MC, Rotterdam 3015 GD, Netherlands; Recruiting
Joost L. Jongen, MD, Phone: +31 (10) 4635754, Email: firstname.lastname@example.org
Joost L. Jongen, MD, Principal Investigator
Enting RH, Mucchiano C, Oldenmenger WH, Fritzon M, Wallen A, Goslinga-van der Gaag S, Sillevis Smitt PA, Delhaas E. The "pain pen" for breakthrough cancer pain: a promising treatment. J Pain Symptom Manage. 2005 Feb;29(2):213-7.
Starting date: August 2005
Ending date: August 2008
Last updated: April 10, 2007