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Inpharma 1662 - 1 Nov 2008 Morphine-6-glucuronide leads to less PONV than morphine Morphine-6-glucouronide (M6G) * is associated with less postoperative nausea and vomiting (PONV) than morphine, according to the results of an study presented at the 2008 Annual Meeting of the American Society of Anesthesiologists. The study involved 517 patients undergoing major abdominal surgery who were randomly assigned to receive postoperative pain management based on either M6G (n = 268) or morphine. The M6G and morphine regimens consisted of an intraoperative loading dose (30 mg/70kg and 10 mg/70kg, respectively) and up to two fixed doses (15mg/70kg and 5 mg/70kg, respectively) plus patient-controlled analgesia (PCA) for a minimum of 24 hours. The AUCs for nausea scores ** from 6 to 24 hours after PCA was commenced increased, as expected, with the number of Apfel risk factors each patient had. Notably, for patients with one, two three, or four Apfel risk factors, M6G was associated with 28%, 14%, 17% and 29% reductions in AUC, respectively, compared with morphine. Overall, when comparing M6G with morphine the nausea severity was reduced by 27% with the experimental agent in patients who received postoperative opioids (p = 0.052) and by 17% in women (p= 0.034). Furthermore, the incidence of vomiting was significantly reduced by 34% in the M6G recipients, compared with the morphine recipients. * M6G is an active potent metabolite of morphine being developed by CeNeS Pharmaceuticals; this product is in phase III in the EU for postoperative pain and in phase I in the US for pain. ** 4-point scale: none, mild, moderate, severe Lees JP, et al. Analysis of PONV and Apfel risk factors in a comparison between morphine-6-glucuronide and morphine. 2008 Annual Meeting of the American Society of Anesthesiologists (Abstr. on disk): abstr. 1695, 18 Oct 2008. Available from: URL: http://www2.asahq.org 801127289 1 Inpharma 1 Nov 2008 No. 1662 1173-8324/10/1662-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Morphine-6-glucuronide leads to less PONV than morphine

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Inpharma 1662 - 1 Nov 2008

Morphine-6-glucuronide leads toless PONV than morphine

Morphine-6-glucouronide (M6G)* is associated withless postoperative nausea and vomiting (PONV) thanmorphine, according to the results of an study presentedat the 2008 Annual Meeting of the American Society ofAnesthesiologists.

The study involved 517 patients undergoing majorabdominal surgery who were randomly assigned toreceive postoperative pain management based on eitherM6G (n = 268) or morphine. The M6G and morphineregimens consisted of an intraoperative loading dose(30 mg/70kg and 10 mg/70kg, respectively) and up totwo fixed doses (15mg/70kg and 5 mg/70kg,respectively) plus patient-controlled analgesia (PCA) fora minimum of 24 hours.

The AUCs for nausea scores** from 6 to 24 hours afterPCA was commenced increased, as expected, with thenumber of Apfel risk factors each patient had. Notably,for patients with one, two three, or four Apfel riskfactors, M6G was associated with 28%, 14%, 17% and29% reductions in AUC, respectively, compared withmorphine. Overall, when comparing M6G withmorphine the nausea severity was reduced by 27% withthe experimental agent in patients who receivedpostoperative opioids (p = 0.052) and by 17% in women(p= 0.034). Furthermore, the incidence of vomiting wassignificantly reduced by 34% in the M6G recipients,compared with the morphine recipients.* M6G is an active potent metabolite of morphine being developed byCeNeS Pharmaceuticals; this product is in phase III in the EU forpostoperative pain and in phase I in the US for pain.** 4-point scale: none, mild, moderate, severe

Lees JP, et al. Analysis of PONV and Apfel risk factors in a comparison betweenmorphine-6-glucuronide and morphine. 2008 Annual Meeting of the AmericanSociety of Anesthesiologists (Abstr. on disk): abstr. 1695, 18 Oct 2008. Availablefrom: URL: http://www2.asahq.org 801127289

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Inpharma 1 Nov 2008 No. 16621173-8324/10/1662-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved