Study uncovers global disparities in clinical trial opioid use

  • Roydhouse JK & al.
  • JAMA Oncol
  • 12 Sep 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Study design

  • Meta-analysis of 8 multinational phase 3 clinical trials in 46 countries involving 9670 patients with metastatic prostate cancer.
  • Funding: None disclosed.

Key results

  • 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).

Limitations

  • Limited to opioids with Anatomical Therapeutic Chemical codes.