Assessing the efficacy of peripherally acting mu-opioid receptor antagonists (PAMORAs) in the treatment of opioid-induced constipation
作者： Victor Chedid , Michael Camilleri , None
DOI: 10.1136/GUTJNL-2018-316824
关键词:
摘要: We read with interest the recent systematic review and network meta-analysis on efficacy of pharmacological treatment opioid-induced constipation (OIC).1 The authors reviewed 27 randomised controlled trials (RCTs) involving 9149 patients concluded that naloxone was best drug in OIC, followed by naldemedine. believe several factors impacted appraisal relative deserve discussion especially meta-analyses no head-to-head trials. 1. Distribution potential for opioid withdrawal: Naloxone is a lipophilic, non-selective competitive receptor antagonist. oral formulation has bioavailability of ~2%; however, it widely distributed, narrow therapeutic index doses required to treat OIC can increase risk withdrawal symptoms. On other hand, peripherally acting mu-opioid antagonists such as naldemedine …
elsevier.com
sci-hub.se 参考文章(10)
Mark Sanders, Stephen Jones, Oliver Löwenstein, Jan-Peter Jansen, Hubert Miles, Karen Simpson, New Formulation of Sustained Release Naloxone Can Reverse Opioid Induced Constipation Without Compromising the Desired Opioid Effects Pain Medicine. ,vol. 16, pp. 1540- 1550 ,(2015) , 10.1111/PME.12775
O Löwenstein, P Leyendecker, M Hopp, U Schutter, PD Rogers, R Uhl, S Bond, W Kremers, T Nichols, B Krain, K Reimer, Combined prolonged-release oxycodone and naloxone improves bowel function in patients receiving opioids for moderate-to-severe non-malignant chronic pain: a randomised controlled trial. Expert Opinion on Pharmacotherapy. ,vol. 10, pp. 531- 543 ,(2009) , 10.1517/14656560902796798
Lynn Webster, Sunita Dhar, Michael Eldon, Lorianne Masuoka, Jaakko Lappalainen, Mark Sostek, A phase 2, double-blind, randomized, placebo-controlled, dose-escalation study to evaluate the efficacy, safety, and tolerability of naloxegol in patients with opioid-induced constipation. Pain. ,vol. 154, pp. 1542- 1550 ,(2013) , 10.1016/J.PAIN.2013.04.024
William D. Chey, Lynn Webster, Mark Sostek, Jaakko Lappalainen, Peter N. Barker, Jan Tack, Naloxegol for Opioid-Induced Constipation in Patients with Noncancer Pain The New England Journal of Medicine. ,vol. 370, pp. 2387- 2396 ,(2014) , 10.1056/NEJMOA1310246
K. Simpson, P. Leyendecker, M. Hopp, S. Müller-Lissner, O. Löwenstein, J. De Andrés, J. Troy Ferrarons, B. Bosse, B. Krain, T. Nichols, W. Kremers, K. Reimer, Fixed-ratio combination oxycodone/naloxone compared with oxycodone alone for the relief of opioid-induced constipation in moderate-to-severe noncancer pain Current Medical Research and Opinion. ,vol. 24, pp. 3503- 3512 ,(2008) , 10.1185/03007990802584454
Maywin Liu, Eric Wittbrodt, Low-Dose Oral Naloxone Reverses Opioid-Induced Constipation and Analgesia Journal of Pain and Symptom Management. ,vol. 23, pp. 48- 53 ,(2002) , 10.1016/S0885-3924(01)00369-4
Winfried Meissner, Petra Leyendecker, Stefan Mueller-Lissner, Joachim Nadstawek, Michael Hopp, Christian Ruckes, Stefan Wirz, Wolfgang Fleischer, Karen Reimer, A randomised controlled trial with prolonged-release oral oxycodone and naloxone to prevent and reverse opioid-induced constipation. European Journal of Pain. ,vol. 13, pp. 56- 64 ,(2009) , 10.1016/J.EJPAIN.2008.06.012
Lynn R Webster, Tadaaki Yamada, Juan Camilo Arjona Ferreira, A Phase 2b, Randomized, Double-Blind Placebo-Controlled Study to Evaluate the Efficacy and Safety of Naldemedine for the Treatment of Opioid-Induced Constipation in Patients with Chronic Noncancer Pain. Pain Medicine. ,vol. 18, pp. 2350- 2360 ,(2017) , 10.1093/PM/PNW325
Martin Hale, James Wild, Jyotsna Reddy, Tadaaki Yamada, Juan Camilo Arjona Ferreira, Naldemedine versus placebo for opioid-induced constipation (COMPOSE-1 and COMPOSE-2): two multicentre, phase 3, double-blind, randomised, parallel-group trials. The Lancet Gastroenterology & Hepatology. ,vol. 2, pp. 555- 564 ,(2017) , 10.1016/S2468-1253(17)30105-X
Pavit Luthra, Nicholas E Burr, Darren M Brenner, Alexander C Ford, Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis Gut. ,vol. 68, pp. 434- 444 ,(2013) , 10.1136/GUTJNL-2018-316001