Abstract:
Naldemedine is indicated for the treatment of opioid-induced constipation (OIC), but reports on its efficacy in preventing OIC are few. Therefore, we retrospectively investigated factors affecting the efficacy of concurrent prescription of naldemedine on OIC. Outpatients with cancer who were started on oxycodone 10 mg/d were included in the study. The eligible patients were classified by their physicians into the following three groups: Group A used regular laxatives before the introduction of oxycodone and initiated naldemedine treatment simultaneously with oxycodone administration, Group B did not take laxatives before the introduction of oxycodone and started naldemedine simultaneously with oxycodone administration, and Group C had been administering regular laxatives before the introduction of oxycodone and were not prescribed naldemedine simultaneously with oxycodone treatment. The Support Team Assessment Schedule Japanese edition score for constipation, frequency of defecation, Bristol Stool Form Scale, sense of incomplete rectal evacuation, and development or worsening of straining to pass bowel movements were compared among the three groups before and after oxycodone administration. In Group B, there was significant worsening of the four parameters except for the sense of incomplete rectal evacuation, whereas Groups A and C did not present any changes. In logistic regression analysis, body weight ≥51.8 kg was a factor significantly decreasing the preventive effect of naldemedine on OIC, and regular use of laxatives was a factor significantly increasing the preventive effect of naldemedine on OIC. Thus, the initiation of naldemedine should be considered depending on the body weight and regular laxative use.
摘要:
Naldemedine用于治疗阿片类药物引起的便秘(OIC),但是关于其预防OIC功效的报道很少。因此,我们回顾性调查了影响纳地米定同步处方治疗OIC疗效的因素.开始服用羟考酮10mg/d的癌症门诊患者纳入研究。医生将符合条件的患者分为以下三组:A组在引入羟考酮之前使用常规泻药,并在羟考酮给药的同时开始纳地定治疗。B组在引入羟考酮之前不服用泻药,并在羟考酮给药的同时开始纳地米定,和C组在引入羟考酮之前一直定期服用泻药,并且不与羟考酮同时服用纳迪米定。支持团队评估时间表日文版便秘评分,排便频率,布里斯托尔凳子表格秤,感觉不完全的直肠排空,比较三组在羟考酮给药前后排便紧张的发展或恶化。B组,除了不完全的直肠排空感之外,四个参数都显着恶化,而A组和C组未出现任何变化。在逻辑回归分析中,体重≥51.8kg是显着降低纳地米定对OIC的预防作用的因素,定期使用泻药是显着增加纳地米定对OIC的预防作用的因素。因此,应根据体重和定期使用泻药考虑开始使用纳地米定。