Title: Recommendations

Context:
A second non-inferiority RCT compared once-daily hydromorphone ER to twice-daily oxycodone  controlled-release in patients with moderate-to-severe cancer pain. The primary efficacy endpoint was  patient assessment of “Brief Pain Inventory (BPI) worst pain in the past 24 hr.” Results demonstrated  similar improvements in BPI and that the once-daily hydromorphone formulation was non-inferior to the  twice-daily oxycodone formulation. Treatment-emergent adverse events were comparable between the  groups as well.[141] The efficacy of long-acting opioids used once-daily is non-inferior to twice-daily use. There was a lack of statistical analysis of the outcomes and a lack of statistical power in both studies, and a  small sample size in one study.

Question: What was the efficacy of long-acting opioids used once-daily compared to twice-daily use?

Answer: non-inferior