• Martin E Hale, Mark S Wallace, Donald R Taylor, Michael Kutch, and Srinivas Nalamachu.
• Gold Coast Research, LLC, Weston, FL, USA.
• J Opioid Manag. 2012 Sep 1;8(5):299-314.

ObjectiveThis analysis was designed to assess the pooled safety and tolerability of once-daily hydromorphone extended release (ER) (OROS® hydromorphone ER) in opioid-naïve and opioid-tolerant patients with chronic cancer or noncancer pain.DesignSafety results were pooled from 13 controlled and uncontrolled clinical studies, with varying approaches to dosing and titration, pain etiology, and duration of exposure.Patients And InterventionsOf the 3,075 patients in the pooled population, 2,335 (76 percent) received at least one dose of OROS hydromorphone ER, with a duration of dosing of up to 1.5 years; 420 patients were treated for at least 6 months and 141 for longer than 1 year.Main Outcome MeasuresThe primary outcome measure was the occurrence of adverse events (AEs). Descriptive statistics were used to analyze the incidence of AEs in the overall population as well as according to baseline characteristics.ResultsOverall AE incidence with OROS hydromorphone ER treatment was 80.5 percent (1,880/2,335 patients). The most common treatment-related AEs were constipation (28.9 percent, 674 patients) and nausea (22.7 percent, 529 patients), and most cases were mild to moderate in severity. The incidence of overall AEs did not undergo a notable change over time. Opioid-related AEs were higher in patients ≥65 years of age, female patients, and opioid-naïve patients. Serious adverse events (SAEs) were reported by 10.2 percent (239) of patients. A total of 64 deaths occurred, none of which were considered related to OROS hydromorphone ER treatment.ConclusionsOROS hydromorphone was generally well tolerated in short- and long-term studies and demonstrated a consistent AE profile over time.

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