Lancet Respir Med

ERS 2025: Low-dose morphine fails to ease chronic breathlessness in placebo-controlled trial

October 3, 2025

Despite its common use in palliative care, morphine didn’t outperform placebo for chronic breathlessness in patients with advanced disease and was associated with more adverse events, according to findings presented at the European Respiratory Society annual meeting.

The UK-based MABEL multi-site, double-blind, randomized, placebo-controlled trial evaluated the clinical and cost effectiveness of low-dose oral modified-release morphine. Researchers enrolled 140 patients with advanced malignant or non-malignant disease and persistent breathlessness. Participants received morphine or placebo with dose titration over four weeks. Primary endpoint was patient-reported worst breathlessness.

Morphine failed to significantly reduce worst breathlessness scores compared with placebo. Secondary outcomes—including breathlessness distress, cough, pain, sleepiness, and physical activity—also showed no meaningful differences. Adverse events were more frequent in the morphine group, though no serious safety concerns were reported.

Source:

Johnson MJ, et al; MABEL collaborative. (2025, September 28). Lancet Respir Med. Morphine for chronic breathlessness (MABEL) in the UK: a multi-site, parallel-group, dose titration, double-blind, randomised, placebo-controlled trial. https://pubmed.ncbi.nlm.nih.gov/41033333/