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We assessed the feasibility, tolerability and possible efficacy of methadone rotation (MR) compared to other opioid rotations (OOR) in this cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Adults with CIBP and worst pain intensity\u2009\u2265\u20094\/10 and\/or opioid toxicity graded\u2009\u2265\u20092 on the Common Terminology Criteria for Adverse Events were randomised 1:1 to methadone or another opioid rotation. Standardised assessment tools were used at pre-defined study time points up to 14\u00a0days.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 51 eligible participants, 38 (74.5%) consented, and 29 (76.3%, MR: 14, OOR: 15) completed the fourteen days follow-up post-opioid rotation. Both groups displayed significant reduction in average (MR: <jats:italic>d<\/jats:italic>\u2009=\u2009\u2009\u2212\u20091.2, <jats:italic>p<\/jats:italic>\u2009=\u20090.003, OOR: <jats:italic>d<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.8, <jats:italic>p<\/jats:italic>\u2009=\u20090.015) and worst pain (MR: <jats:italic>d<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.042, OOR: <jats:italic>d<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.048) and total pain interference score (MR: <jats:italic>d<\/jats:italic>\u2009=\u2009\u2009\u2212\u20091.1, <jats:italic>p<\/jats:italic>\u2009=\u20090.042, OOR: <jats:italic>d<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.7, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Oral morphine equivalent daily dose was reduced significantly in MR compared to the OOR group (<jats:italic>d<\/jats:italic>\u2009=\u2009\u2009\u2212\u20090.8, <jats:italic>p<\/jats:italic>\u2009=\u20090.05). The incidence of opioid-related adverse events following MR was unchanged but lower in the OOR group (<jats:italic>d<\/jats:italic>\u2009=\u20090.9, 95% CI 0.1,1.7, <jats:italic>p<\/jats:italic>\u2009=\u20090.022). There were no within-group or between-group differences in satisfaction with analgesia at the end of the study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This pilot study demonstrated that MR and OOR in patients with refractory CIBP are feasible, safe and acceptable to patients. Appropriately powered multi-centre randomised controlled studies are needed to confirm the efficacy of MR and OOR in this cohort.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ACTRN12621000141842 registered 11 February 2021.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00520-024-08706-w","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T06:01:50Z","timestamp":1720504910000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Methadone versus other opioids for refractory malignant bone pain: a pilot randomised controlled study"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5610-4023","authenticated-orcid":false,"given":"Merlina","family":"Sulistio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Gorelik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoong Jiun","family":"Tee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Wojnar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kissane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3603-1258","authenticated-orcid":false,"given":"Natasha","family":"Michael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"8706_CR1","doi-asserted-by":"publisher","first-page":"h315","DOI":"10.1136\/bmj.h315","volume":"350","author":"CM Kane","year":"2015","unstructured":"Kane CM, Hoskin P, Bennett MI (2015) Cancer induced bone pain. 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