Cochrane · systematic review · CD011108
Hydromorphone for cancer pain
Li, Y, Ma, J, Lu, G, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
12
No studies
9
Included studies
NR
No studies 9 · 42.9%Ungraded 0 · 0%Very low 12 · 57.1%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyHydromorphone compared with oxycodone for people with moderate to severe cancer pain
Population: people with moderate to severe cancer pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported pain intensity (as measured by VAS or BPI) Hydromorphone vs oxycodone | no estimate extracted | 4 studies · 462 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Participant‐reported pain relief Hydromorphone vs oxycodone | no estimate extracted | NR | No studies |
Specific adverse events – nausea Hydromorphone vs oxycodone | RR 1.13 [0.74, 1.73] | 3 studies · 622 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Specific adverse events – vomiting Hydromorphone vs oxycodone | RR 1.18 [0.72, 1.94] | 3 studies · 622 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Specific adverse events – dizziness Hydromorphone vs oxycodone | RR 0.91 [0.58, 1.44] | 2 studies · 441 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Specific adverse events – constipation Hydromorphone vs oxycodone | RR 0.92 [0.72, 1.19] | 3 studies · 622 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Quality of life Hydromorphone vs oxycodone | no estimate extracted | NR | No studies |
Hydromorphone compared with morphine for people with moderate to severe cancer pain
Population: people with moderate to severe cancer pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported pain intensity (as measured by BPI and VAS) Hydromorphone vs morphine | no estimate extracted | 2 studies · 433 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Participant‐reported pain relief Hydromorphone vs morphine | RR 0.99 [0.84, 1.18] | 1 study · 233 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Specific adverse events – nausea Hydromorphone vs morphine | RR 0.94 [0.66, 1.3] | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Specific adverse events – vomiting Hydromorphone vs morphine | RR 0.87 [0.58, 1.31] | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Specific adverse events – dizziness Hydromorphone vs morphine | RR 1.15 [0.71, 1.88] | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Specific adverse events – constipation Hydromorphone vs morphine | no estimate extracted | 2 studies · 433 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Quality of life Hydromorphone vs morphine | no estimate extracted | NR | No studies |
Hydromorphone compared with fentanyl for people with moderate to severe cancer pain
Population: people with moderate to severe cancer pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported pain intensity (as measured by NRS) Hydromorphone vs fentanyl | no estimate extracted | 1 study · 82 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Participant‐reported pain relief Hydromorphone vs fentanyl | no estimate extracted | NR | No studies |
Specific adverse events – nausea Hydromorphone vs fentanyl | no estimate extracted | NR | No studies |
Specific adverse events – vomiting Hydromorphone vs fentanyl | no estimate extracted | NR | No studies |
Specific adverse events – dizziness Hydromorphone vs fentanyl | no estimate extracted | NR | No studies |
Specific adverse events – constipation Hydromorphone vs fentanyl | no estimate extracted | NR | No studies |
Quality of life Hydromorphone vs fentanyl | no estimate extracted | NR | No studies |
Hydromorphone compared to oxycodone for cancer pain
Population: people with cancer pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported pain intensity Hydromorphone vs oxycodone | no estimate extracted | 1 study · 31 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ nausea Hydromorphone vs oxycodone | no estimate extracted | 1 study · 254 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ constipation Hydromorphone vs oxycodone | no estimate extracted | 1 study · 254 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ vomiting Hydromorphone vs oxycodone | no estimate extracted | 1 study · 254 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Leaving the study early Hydromorphone vs oxycodone | RR 0.61 [0.2, 1.87] | 2 studies · 304 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Death Hydromorphone vs oxycodone | no estimate extracted | 1 study · 260 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Hydromorphone compared to morphine for cancer pain
Population: people with cancer pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant‐reported pain intensity Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ confusion Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ headache Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ insomnia Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ nausea Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Adverse events ‐ pyrexia Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Death Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Leaving the study early ‐ overall Hydromorphone vs morphine | no estimate extracted | 1 study · 200 participants | Very low Downgraded: risk of bias, imprecision, publication bias |