{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:14:44Z","timestamp":1792253684784,"version":"4.4.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2008,4,1]],"date-time":"2008-04-01T00:00:00Z","timestamp":1207008000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2008,4]]},"abstract":"<jats:p>Adequate and rapid pain control is one of the main goals of cancer pain treatment. The objective of this study was to assess the effect and tolerability of oral normal-release morphine during the initial phase of treatment in patients with moderate-to-severe cancer pain. Consecutive patients na\u00efve to strong opioids received normal-release morphine 5 or 10\u00a0mg every 4\u00a0h during the titration phase (first 5\u00a0days), depending on previous analgesic therapy. Pain intensity was assessed using an 11-point Numerical Rating Scale (0\u201310), and data were recorded in a patient-compiled diary. The primary endpoint was the proportion of time with pain control (a reduction of at least 50% with respect to the baseline pain score) during the titration phase. A total of 159 consecutive patients (102 men; mean age 65\u00a0years) with cancer-related pain were enrolled. Pain control was observed for 75% (95% CI 70\u201380) of the follow-up period in the intent-to-treat population. Overall, 50% and 75% of patients achieved pain control within 8 and 24\u00a0h after starting normal-release morphine therapy respectively. The mean pain score was 7.63 points at baseline, and decreased to 2.43 and 1.67 points (both P\u00a0&lt;\u00a00.001) at days 3 and 5 respectively. The most commonly reported adverse events were somnolence (24% of patients), constipation (22%), vomiting (13%), nausea (10%) and confusion (7%). Normal-release morphine results in rapid and satisfactory pain control, and is well tolerated, during the strong-opioid titration phase in patients with moderate-to-severe cancer pain.<\/jats:p>","DOI":"10.1177\/0269216308088692","type":"journal-article","created":{"date-parts":[[2008,5,13]],"date-time":"2008-05-13T11:57:48Z","timestamp":1210679868000},"page":"214-221","source":"Crossref","is-referenced-by-count":33,"title":["The MERITO Study: a multicentre trial of the analgesic effect and                 tolerability of normal-release oral morphine during \u2018titration                 phase\u2019 in patients with cancer pain"],"prefix":"10.1177","volume":"22","author":[{"given":"F","family":"De Conno","sequence":"first","affiliation":[{"name":"Rehabilitation and Palliative Care Operative Unit, IRCCS Foundation,                         National Cancer Institute, Milano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Ripamonti","sequence":"additional","affiliation":[{"name":"Rehabilitation and Palliative Care Operative Unit, IRCCS Foundation,                         National Cancer Institute, Milano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Fagnoni","sequence":"additional","affiliation":[{"name":"Rehabilitation and Palliative Care Operative Unit, IRCCS Foundation,                         National Cancer Institute, Milano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Rehabilitation and Palliative Care Operative Unit, IRCCS Foundation,                         National Cancer Institute, Milano"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Luzzani","sequence":"additional","affiliation":[{"name":"IST Istituto Naz.le ricerca sul Cancro S.C. 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Oncologico Unit\u00e0 Cure Palliative                         Hospice, Forl\u00ec"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Arcuri","sequence":"additional","affiliation":[{"name":"Istituto Regina Elena, UOC Rianimazione Terapia Intensiva Terapia del                         Dolore e Cure Palliative, Roma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Bertetto","sequence":"additional","affiliation":[{"name":"Ospedale Le Molinette, Torino"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of MERITO Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2008,4,1]]},"reference":[{"key":"atypb1","first-page":"316","volume-title":"Oxford textbook of palliative medicine","author":"Hanks G","year":"2004","edition":"3"},{"key":"atypb2","volume-title":"Cancer pain relief.","author":"World Health Organization","year":"1986"},{"key":"atypb3","volume-title":"Cancer pain relief","author":"World Health Organization","year":"1996","edition":"2"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7034.823"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.2001.1680"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10249"},{"key":"atypb11","volume-title":"British National Formulary","author":"Joint Formulary Committee","year":"2007","edition":"53"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1177\/026921638700100203"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1191\/0269216305pm1054oa"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1191\/0269216305pm1002oa"},{"key":"atypb15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13819-6"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-005-0918-0"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.300.6719.230"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.214"},{"key":"atypb20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1989.tb05399.x"},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(91)90042-3"},{"key":"atypb22","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.9.2542"},{"key":"atypb23","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(95)00076-3"},{"key":"atypb24","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00073-1"},{"key":"atypb25","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(92)90256-B"},{"key":"atypb26","first-page":"87","volume":"21","author":"Zeppetella G","year":"2001","journal-title":"J Pain Symptom Manage"},{"key":"atypb27","doi-asserted-by":"publisher","DOI":"10.1191\/026921601668030190"},{"key":"atypb28","doi-asserted-by":"publisher","DOI":"10.1054\/jpai.2002.27136"},{"key":"atypb29","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00293-2"},{"key":"atypb30","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(91)90163-R"},{"key":"atypb31","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(90)90004-W"},{"key":"atypb32","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(98)00045-1"},{"key":"atypb33","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92425-S"}],"container-title":["Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269216308088692","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269216308088692","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:15:06Z","timestamp":1777659306000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0269216308088692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,4]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2008,4]]}},"alternative-id":["10.1177\/0269216308088692"],"URL":"https:\/\/doi.org\/10.1177\/0269216308088692","relation":{},"ISSN":["0269-2163","1477-030X"],"issn-type":[{"value":"0269-2163","type":"print"},{"value":"1477-030X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,4]]}}}