Journal of Pain and Symptom Management
Volume 38, Issue 5 , Pages 663-672 , November 2009

The INFUSE-Morphine Study: Use of Recombinant Human Hyaluronidase (rHuPH20) to Enhance the Absorption of Subcutaneously Administered Morphine in Patients with Advanced Illness

  • Jay R. Thomas, MD, PhD

      Affiliations

    • Department of Supportive Care Medicine, City of Hope, Duarte, California, USA
    • Corresponding Author InformationAddress correspondence to: Jay R. Thomas, MD, PhD, City of Hope, 1500 East Duarte Road, Machris 1111, Duarte, CA 91010-3000, USA.
    • ,
  • Mark S. Wallace, MD

      Affiliations

    • Department of Anesthesiology, University of California, San Diego Center for Pain Medicine, San Diego, California, USA
    • ,
  • Richard C. Yocum, MD

      Affiliations

    • Department of Drug Development and Medical Affairs, Rockwell Medical Technologies, Inc., Wixom, Michigan, USA
    • ,
  • Daniel E. Vaughn, PhD

      Affiliations

    • Department of Research and Development, Halozyme Therapeutics, Inc., San Diego, California, USA
    • ,
  • Michael F. Haller, PhD

      Affiliations

    • Department of Research and Development, Halozyme Therapeutics, Inc., San Diego, California, USA
    • ,
  • Jocelyne Flament, MD

      Affiliations

    • European Organisation for Research and Treatment of Cancer AISBL-IVZW, Brussels, Belgium

,Accepted 1 April 2009.

References 

  1. Bookbinder LH, Hofer A, Haller MF, et al. A recombinant human enzyme for enhanced interstitial transport of therapeutics. J Control Release. 2006;114:230–241
  2. Frost GI. Recombinant human hyaluronidase (rHuPH20): an enabling platform for subcutaneous drug and fluid administration. Expert Opin Drug Deliv. 2007;4:427–440
  3. Grune F, Schrappe M, Basten J, et al. Phlebitis rate and time kinetics of short peripheral intravenous catheters. Infection. 2004;32:30–32
  4. Kurul S, Saip P, Aydin T. Totally implantable venous-access ports: local problems and extravasation injury. Lancet Oncol. 2002;3:684–692
  5. Monreal M, Davant E. Thrombotic complications of central venous catheters in cancer patients. Acta Haematol. 2001;106:69–72
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  9. Hanks GW, de Conno F, Cherny N, et al. Morphine and alternative opioids in cancer pain: the EAPC recommendations. Br J Cancer. 2001;84:587–593
  10. Elsner F, Radbruch L, Loick G, Gartner J, Sabatowski R. Intravenous versus subcutaneous morphine titration in patients with persisting exacerbation of cancer pain. J Palliat Med. 2005;8:743–750
  11. Kilpatrick GJ, Smith TW. Morphine-6-glucuronide: actions and mechanisms. Med Res Rev. 2005;25:521–544
  12. Hanna MH, Elliott KM, Fung M. Randomized, double-blind study of the analgesic efficacy of morphine-6-glucuronide versus morphine sulfate for postoperative pain in major surgery. Anesthesiology. 2005;102:815–821
  13. Lipschitz S, Campbell AJ, Roberts MS, et al. Subcutaneous fluid administration in elderly subjects: validation of an under-used technique. J Am Geriatr Soc. 1991;39:6–9
  14. Morsman CD, Holden R. The effects of adrenaline, hyaluronidase and age on peribulbar anaesthesia. Eye. 1992;6(Pt 3):290–292
  15. Nathan N, Benrhaiem M, Lotfi H, et al. The role of hyaluronidase on lidocaine and bupivacaine pharmacokinetics after peribulbar blockade. Anesth Analg. 1996;82:1060–1064
  16. Nelson KA, Glare PA, Walsh D, Groh ES. A prospective, within-patient, crossover study of continuous intravenous and subcutaneous morphine for chronic cancer pain. J Pain Symptom Manage. 1997;13:262–267

 Halozyme Therapeutics, Inc. funded the study. Baxter Healthcare Corporation supported the study with documents, database, and statistical analysis. Editorial assistance in the preparation of this manuscript was provided by Barbara J. Goldman, RPh, of Advogent and funded by Baxter.

 At the time the study was conducted, Dr. Flament was employed by Baxter Healthcare Corporation, Deerfield, IL, and Dr. Yocum was employed by Halozyme Therapeutics, Inc., San Diego, CA.

 Clinical Trial Registration: www.ClinicalTrials.gov, Identifier: NCT00593281.

PII: S0885-3924(09)00727-1

doi: 10.1016/j.jpainsymman.2009.03.009

Journal of Pain and Symptom Management
Volume 38, Issue 5 , Pages 663-672 , November 2009

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