Efficacy and safety of naloxegol for opioid-induced constipation assessed by specific opioid medication, opioid dose, and duration of opioid use

Nalamachu, Srinivas; Gudin, Jeffrey; Datto, Catherine; Coyne, Karin S.; Poon, Jiat Ling; Hu, Yiqun

doi:10.5055/jom.2018.0451

Cited by 6 publications

(2 citation statements)

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“…It was important to reduce opioid consumption because it has some side effects such as addiction, nausea, vomiting, constipation, and so on. In our study, there was a lower incidence of constipation, which may be the result of lower morphine consumption 27…”

Section: Discussionsupporting

confidence: 52%

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

Liu²,

Zeng

et al. 2018

JPR

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PurposePregabalin is commonly used as an analgesic for neuropathic pain. But pregabalin as an adjunct to a multimodal analgesic regimen – although standard clinical protocol in some settings – has remained controversial. This meta-analysis was conducted to identify the efficacy of pregabalin for management of postoperative pain in thoracotomy.Materials and methodsPubmed, Embase, Cochrane, Web of Science, Springer, and Clinical Trial Register database were searched for randomized controlled trials (RCTs) of pregabalin in preventing postoperative pain in thoracotomy. Review Manager 5.3 and STATA 12.0 were selected to conduct the meta-analysis. Trial sequential analysis was used to control random errors and calculate the required information size.ResultsNine RCTs with 684 patients were included in our meta-analysis. Outcomes favoring pregabalin included less pain on a 0–10 scale on 1 day [mean difference (MD): −0.87; 95% CI: −1.55 to −0.19; P=0.01], 3 days (MD: −1.55; 95% CI: −1.93 to −1.18; P<0.00001), 1 month (MD: −1.58; 95% CI: −2.75 to −0.42; P=0.008), 3 months (MD: −1.69; 95% CI: −2.71 to −0.66; P=0.001) postoperatively, and less incidence of neuropathic pain (OR: 0.20; 95% CI: 0.05–0.91; P=0.04), less mean morphine consumption (MD: −5.03; 95% CI: −8.06 to −1.99; P=0.001), but more dizziness (OR: 3.33; 95% CI: 1.36–8.17; P=0.009), more drowsiness (OR: 8.61; 95% CI: 2.23–33.20; P=0.002), and less constipation (OR: 0.23; 95% CI: 0.09–0.59; P=0.002). There was no statistical differences in pain score on 7 days (MD:–0.77; 95% CI: −2.38 to 0.84; P=0.35), nausea (OR: 0.73; 95% CI: 0.42–1.26; P=0.26), and vomiting (OR: 0.83; 95% CI: 0.36–1.90; P=0.65).ConclusionPregabalin can prevent postoperative pain in thoracotomy and decrease incidence of neuropathic pain and morphine consumption. Pregabalin may be a valuable asset in management of acute and persistent postoperative pain in thoracotomy.

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Section: Discussionsupporting

confidence: 52%

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

Liu²,

Zeng

et al. 2018

JPR

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“…A recent retrospective analysis of 1,300 patients revealed that 25 mg naloxegol had similar efficacy in treating OIC regardless of the maintenance opioid type, dose, or duration of opioid use at baseline [70].…”

Section: Main Bodymentioning

confidence: 99%

Opioid-induced constipation: a narrative review of therapeutic options in clinical management

Lang-Illievich

Bornemann‐Cimenti

2019

Korean J Pain

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Pain therapy often entails gastrointestinal adverse events. While opioids are effective drugs for pain relief, the incidence of opioid-induced constipation (OIC) varies greatly from 15% to as high as 81%. This can lead to a significant impairment in quality of life, often resulting in discontinuation of opioid therapy. In this regard, a good doctor-patient relationship is especially pivotal when initiating opioid therapy. In addition to a detailed history of bowel habits, patient education regarding the possible gastrointestinal side effects of the drugs is crucial. In addition, the bowel function must be regularly evaluated for the entire duration of treatment with opioids. Furthermore, if the patient has preexisting constipation that is well under control, continuation of that treatment is important. In the absence of such history, general recommendations should include sufficient fluid intake, physical activity, and regular intake of dietary fiber. In patients of OIC with ongoing opioid therapy, the necessity of opioid use should be critically reevaluated in terms of an with acceptable quality of life, particularly in cases of non-cancer pain. If opioids must be continued, lowering the dose may help, as well as changing the type of opioid. If these measures do not suffice, the next step for persistent OIC is the administration of laxatives. If these are ineffective as well, treatment with peripherally active μ-opioid receptor antagonists should be considered. Enemas and irrigation are emergency measures, often used as a last resort.

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Prevalence of drug-induced constipation and severity of associated biopsychosocial effects in patients with nonmalignant pain: a cross-sectional review of depersonalized data from the German Pain e-Registry

Ueberall¹,

Essner²,

Müller-Schwefe

et al. 2021

Current Medical Research and Opinion

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Efficacy and safety of naloxegol for opioid-induced constipation assessed by specific opioid medication, opioid dose, and duration of opioid use

Cited by 6 publications

References 0 publications

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

The efficacy of pregabalin for the management of acute and chronic postoperative pain in thoracotomy: a meta-analysis with trial sequential analysis of randomized-controlled trials

Opioid-induced constipation: a narrative review of therapeutic options in clinical management

Prevalence of drug-induced constipation and severity of associated biopsychosocial effects in patients with nonmalignant pain: a cross-sectional review of depersonalized data from the German Pain e-Registry

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