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Response Rates to Methylnaltrexone in Hospitalized Cancer Patients.

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Methylnaltrexone effectively treats opioid-induced constipation (OIC) in hospitalized cancer patients. A high response rate was observed, particularly in patients with higher oral morphine equivalent (OME) doses.

Keywords:
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Area of Science:

  • Oncology
  • Palliative Care
  • Pharmacology

Background:

  • Opioid-induced constipation (OIC) is a common side effect in cancer patients.
  • Methylnaltrexone, a peripherally-acting mu-opioid receptor antagonist, is used for OIC, primarily in outpatients.
  • Its efficacy in hospitalized cancer patients with OIC is not well-established.

Purpose of the Study:

  • To evaluate the effectiveness of methylnaltrexone for OIC in adult inpatients with cancer.
  • To determine the rate of bowel movement (BM) within 24 hours of methylnaltrexone administration.

Main Methods:

  • Retrospective chart review of 194 hospitalized adult cancer patients receiving methylnaltrexone.
  • Data collected on patient demographics, dosage, oral morphine equivalent (OME), and BM within 24 hours.
  • Analysis of factors influencing response, including OME and prior laxative use.

Main Results:

  • 45% of patients achieved a BM within 24 hours of methylnaltrexone administration.
  • A significantly higher response rate (93%) was observed in patients receiving ≥150 mg OME compared to <150 mg OME (2%).
  • Prior use of osmotic laxatives, stimulant laxatives, or stool softeners did not predict response.

Conclusions:

  • Methylnaltrexone demonstrates a high response rate for OIC in hospitalized adult cancer patients.
  • Higher OME is strongly correlated with successful treatment outcomes.
  • Methylnaltrexone is an effective option for managing OIC in this patient population.