Therefore, we updated the data and re-performed a systematic review of all related literatures to evaluate efficacy and adverse effects of transdermal fentanyl and oral morphine treating moderate-severe cancer pain in Chinese population. Methods Search Strategy Two authors independently performed a systematic review of electronic databases including Chinese Biomedical Literature Analysis and Retrieval System (CBMdisc), China National Knowledge Infrastructure

Syk inhibitor (CNKI), Chongqi VIP Information (VIP), Medline, EMBASE and Cochrane click here library. The following keywords were used in the search: transdermal fentanyl, morphine, sustained-release morphine, Durogesic, MS Contin, Morphine Hydrochloride-Southwest Pharm. In addition to the online search, references from original articles also were scanned to capture missing clinical trial data that met our inclusion criteria. All papers comparing transdermal fentanyl with sustained-release oral morphine (MS Contin or Morphine Hydrochloride-Southwest Pharm) were examined. No language restrictions were applied. The deadline of last search was December 31, 2009. Inclusion Criteria Study design Trials should be prospective cohort study, which were matched for sex, age, performance status, and type of tumor.

Study population Patients were Chinese and suffered from moderate-severe cancer pain. In addition, patients who were eligible for trials didn’t receive radiotherapy, chemotherapy or immunotherapy in 30 days prior to analgesics administration, and patients had no history of hypersensitive to opioid or opioid abuse. many Patients had adequate hematological, ACP-196 supplier renal, cardiac and hepatic

function. Interventions The treatment arm received transdermal fentanyl (Durogesic), the control arm received sustained-release oral morphine (MS Contin or Morphine Hydrochloride-Southwest Pharm). The treatment duration was 15 days at least. End Points The primary end points were remission rate of pain and incidence of opioids-related adverse effects. The second end point was quality of life (QOL). Data Extraction Two primary reviewers (QY and DRX) assessed all abstracts that were identified from the above-mentioned sources. Both reviewers independently selected trials according to inclusion criteria. Disagreements were resolved by consensus or by the third reviewer (ZMJ). Following data were requested: number of patients recruited, number of patients had remission, number of patients had non-remission, number of patients experienced constipation, number of patients experienced nausea and vomiting (nausea/vomiting), number of patients experienced vertigo and somnolence (vertigo/somnolence) and QOL from each trial. Assessment of Study Quality We assessed all manuscripts that met the selection criteria for quality. Quality assessment was based on published checklists.