- Patients in Asian and Eastern European countries are less likely than those in North America to use opioids in prostate cancer clinical trials.
- High within-region variability is observed in Asia, Eastern Europe, Western Europe, and the Middle East.
- Opioid use is higher in high-income countries.
Why this matters
- Findings suggest that international trials should include opioid use as an endpoint.
- Meta-analysis of 8 multinational phase 3 clinical trials in 46 countries involving 9670 patients with metastatic prostate cancer.
- Funding: None disclosed.
- 86.5% of patients resided in high-income countries.
- 50.4% reported opioid use while on trial.
- Opioid use was lower in Asia (33.0%) and Eastern Europe (30.7%) than North America (59.1%), Oceania (54.1%), and Western Europe (56.1%).
- Compared with North America, opioid use was significantly lower in Asia (aOR, 0.31; 95% CI, 0.25-0.38) and Eastern Europe (aOR, 0.19; 95% CI, 0.16-0.22).
- Opioid consumption rate varied within Asia (15.0%-50.9%), Eastern Europe (9.0%-55.1%), the Middle East (32.7%-60.0%), and Western Europe (36.4%-83.2%).
- Opioid use was similar in the United States and Canada (aOR, 1.13; 95% CI, 0.93-1.37).
- Odds of opioid intake were significantly greater in high-income countries (aOR, 5.29; 95% CI, 4.59-6.10).
- Limited to opioids with Anatomical Therapeutic Chemical codes.