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Nuevos antagonistas opioides para la disfunción intestinal inducida por opioides y el ileo postoperatorio
Gerhild Becker1, Hubert E Blum
1Department of Palliative Care, University Hospital Freiburg, Freiburg, Germany.
Lancet (London, England)
|February 17, 2009
Resumen
Los nuevos medicamentos, la metilnaltrexona y el alvimopan, tratan eficazmente los efectos secundarios gastrointestinales inducidos por los opioides sin afectar el alivio del dolor. Ambos muestran una promesa para la disfunción intestinal relacionada con los opioides y el íleus postoperatorio.
Área de la Ciencia:
- Farmacología Farmacología.
- Gastroenterología y Gastroenterología.
- Desarrollo de Drogas Desarrollo de Drogas.
Sus antecedentes:
- Los medicamentos opioides comúnmente causan efectos secundarios gastrointestinales, lo que afecta la comodidad del paciente y la adherencia al tratamiento.
- Los tratamientos existentes para estos efectos secundarios a menudo comprometen el manejo del dolor.
- Los antagonistas de los receptores mu-opioides de acción periférica ofrecen un nuevo enfoque para mitigar estos problemas.
Objetivo del estudio:
- Proporcionar una visión general de la farmacología, la eficacia y los efectos adversos de la metilnaltrexona y el alvimopan.
- Evaluar su potencial en el manejo de la disfunción intestinal relacionada con los opioides y el ileus postoperatorio.
- Para discutir su estado regulatorio actual y las futuras necesidades de investigación.
Principales métodos:
- Revisión de los datos farmacológicos para la metilnaltrexona y el alvimopan.
- Análisis de los resultados de ensayos clínicos con respecto a la eficacia y seguridad.
- Examen de las aprobaciones regulatorias y las restricciones asociadas.
Principales resultados:
- Tanto la metilnaltrexona como el alvimopan parecen ser bien tolerados y efectivos para la disfunción intestinal relacionada con los opioides y el íleo postoperatorio.
- La metilnaltrexona está aprobada para pacientes con enfermedad avanzada con disfunción intestinal relacionada con opioides.
- Alvimopan está aprobado para el íleo postoperatorio, pero tiene preocupaciones sobre eventos cardíacos, lo que restringe su uso.
Conclusiones:
- La metilnaltrexona y el alvimopan representan una nueva clase prometedora de fármacos para el manejo de los efectos secundarios gastrointestinales inducidos por los opioides.
- Es esencial realizar más investigaciones clínicas para evaluar plenamente su eficacia y seguridad a largo plazo en diversas poblaciones de pacientes.
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