BEAMS (morphine 8 mg)
Trial question
What is the effect of extended-release morphine in patients with COPD?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
47.0% female
53.0% male
N = 105
105 patients (49 female, 56 male).
Inclusion criteria: adult patients with COPD and chronic breathlessness.
Key exclusion criteria: receipt of opioids; morphine allergy; central hypoventilation syndrome; pregnancy; liver or kidney failure.
Interventions
N=55 morphine (at an extended-release oral dose of 8 mg/day).
N=50 placebo (matching placebo daily).
Primary outcome
Reduction in intensity of worst breathlessness at week 1
0.8
0.7
0.8
0.6
0.4
0.2
0.0
Morphine
Placebo
No significant
difference ↔
No significant difference in reduction in intensity of worst breathlessness at week 1 (0.8 vs. 0.7; AD 0.3 , 95% CI -0.4 to 0.9).
Secondary outcomes
No significant difference in reduction in daily step count at week 1 (84 vs. 99; AD 39 , 95% CI -501 to 579).
No significant difference in reduction in intensity of breathlessness at week 1 (0.6 vs. 0.6; AD 0.1 , 95% CI -0.5 to 0.7).
No significant difference in reduction in overall breathlessness distress level at week 1 (1 vs. 0.7; AD 0.4 , 95% CI -0.4 to 1.1).
Safety outcomes
No significant differences in anxiety, dyspnea, nausea.
Conclusion
In adult patients with COPD and chronic breathlessness, morphine was not superior to placebo with respect to reduction in intensity of worst breathlessness at week 1.
Reference
Magnus Ekström, Diana Ferreira, Sungwon Chang et al. Effect of Regular, Low-Dose, Extended-release Morphine on Chronic Breathlessness in Chronic Obstructive Pulmonary Disease: The BEAMS Randomized Clinical Trial. JAMA. 2022 Nov 22;328(20):2022-2032.
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