Response Rates to Methylnaltrexone in Hospitalized Cancer Patients
Context: Methylnaltrexone is a peripherally-acting mu-opioid receptor antagonist studied in both cancer and non-cancer patients with opioid-induced constipation (OIC), but mostly in the outpatient setting. For adult hospitalized cancer patients with OIC, its effectiveness is unknown. Objectives: Describe the efficacy of methylnaltrexone for OIC in the inpatient setting, defined as bowel movement (BM) within 24 hours of methylnaltrexone administration. Methods: We performed a single-center, retrospective chart review of all hospitalized, adult patients with a cancer diagnosis who received methylnaltrexone from the palliative care team between January 1st, 2012 and July 1st, 2019. Results: We identified 194 patients. The mean age was 59, 50.5% were male and 88% were white. 192 patients (98%) received the 8 mg dose subcutaneously. The median oral morphine equivalent (OME) was 135 mg (IQR 70-354 mg). 45% (95% confidence interval, 38-53%) had a BM within 24 hours. Higher OME was correlated with successful BM, with a response in 93% (86/92) of patients receiving ≥150 OME and 2% (2/102) of patients receiving <150 OME (P < .0001). Prior laxative use did not predict response at 24 hours whether these were osmotic laxatives (40.7% vs 47.1%, P = .52), stimulant laxatives (45.7% vs 45.2%, P > .99), or stool softeners (44.7% vs 46.1%, P = .89). Conclusion: Methylnaltrexone has a high response rate when used as treatment for OIC in hospitalized adult cancer patients, especially for patients taking ≥150 OME.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
The American journal of hospice & palliative care - 40(2023), 10 vom: 24. Okt., Seite 1093-1097 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Harris, David [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 19.09.2023 Date Revised 19.09.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/10499091221147903 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM350767564 |
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| 500 | |a Date Completed 19.09.2023 | ||
| 500 | |a Date Revised 19.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Context: Methylnaltrexone is a peripherally-acting mu-opioid receptor antagonist studied in both cancer and non-cancer patients with opioid-induced constipation (OIC), but mostly in the outpatient setting. For adult hospitalized cancer patients with OIC, its effectiveness is unknown. Objectives: Describe the efficacy of methylnaltrexone for OIC in the inpatient setting, defined as bowel movement (BM) within 24 hours of methylnaltrexone administration. Methods: We performed a single-center, retrospective chart review of all hospitalized, adult patients with a cancer diagnosis who received methylnaltrexone from the palliative care team between January 1st, 2012 and July 1st, 2019. Results: We identified 194 patients. The mean age was 59, 50.5% were male and 88% were white. 192 patients (98%) received the 8 mg dose subcutaneously. The median oral morphine equivalent (OME) was 135 mg (IQR 70-354 mg). 45% (95% confidence interval, 38-53%) had a BM within 24 hours. Higher OME was correlated with successful BM, with a response in 93% (86/92) of patients receiving ≥150 OME and 2% (2/102) of patients receiving <150 OME (P < .0001). Prior laxative use did not predict response at 24 hours whether these were osmotic laxatives (40.7% vs 47.1%, P = .52), stimulant laxatives (45.7% vs 45.2%, P > .99), or stool softeners (44.7% vs 46.1%, P = .89). Conclusion: Methylnaltrexone has a high response rate when used as treatment for OIC in hospitalized adult cancer patients, especially for patients taking ≥150 OME | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a constipation | |
| 650 | 4 | |a hospice | |
| 650 | 4 | |a methylnaltrexone | |
| 650 | 4 | |a opioid induced constipation | |
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| 700 | 1 | |a Kalir, David |e verfasserin |4 aut | |
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| 700 | 1 | |a Dobbie, Krista |e verfasserin |4 aut | |
| 700 | 1 | |a Fielding, Flannery |e verfasserin |4 aut | |
| 700 | 1 | |a Lagman, Ruth |e verfasserin |4 aut | |
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| 700 | 1 | |a McInnes, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Najafi, Sina |e verfasserin |4 aut | |
| 700 | 1 | |a Neale, Kyle |e verfasserin |4 aut | |
| 700 | 1 | |a Rybicki, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Robbins-Ong, Melanie |e verfasserin |4 aut | |
| 700 | 1 | |a Neuendorf, Kathleen |e verfasserin |4 aut | |
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