在患有癌症和没有癌症的患者中治疗阿片类药物诱导的便秘的甲基利治疗:初始剂量的影响
Bruce H Chamberlain1, Michelle Rhiner2, Neal E Slatkin3,4
1Genesis Healthcare, Davenport, IA, USA.
Journal of pain research
|August 3, 2023
概括
甲基纳特雷克松有效治疗患有癌症和非癌症疼痛的患者的阿片类药物诱导便秘 (OIC). 这种药物迅速诱导脱而不会影响疼痛缓解,表现出良好的耐受性.
科学领域:
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
- 在瘤学瘤学.
背景情况:
- 阿片类药物引起的便秘 (OIC) 是阿片类药物治疗的常见并发症.
- 甲基纳特雷克松 (MNTX) 是一种外围作用的μ-阿片类受体对手,旨在抵消OIC.
- 之前的研究表明,MNTX在治疗OIC中的有效性.
研究的目的:
- 评价和比较初始剂量甲基纳特雷克松 (MNTX) 在患有OIC的患者的疗效.
- 为了分析慢性疼痛患者的癌症存在或不存在的分层治疗反应.
主要方法:
- 来自三项随机,安慰剂控制的临床试验的综合数据的后期分析,这些临床试验涉及晚期疾病和OIC患者.
- 关键的评估包括在4小时和24小时内无救助脱 (RFL),RFL的时间,疼痛强度和不良事件.
- 数据根据癌症状态进行了分层分类.
主要成果:
- 在癌症和非癌症组中,甲基利显著增加了与安慰剂相比,在4小时和24小时内达到RFL的患者比例 (p<0.0001).
- 治疗MNTX导致RFL的时间更短,在癌症和非癌症患者中观察到类似的响应率.
- 副作用主要是胃肠道 (腹痛,浮,恶心),所有组的疼痛得分都保持稳定.
结论:
- 甲基纳特雷克松在OIC患者中,无论癌症状况如何,都能快速有效地诱导脱.
- 在MNTX治疗期间,阿片类止痛药的疗效保持不变.
- 甲基纳尔特雷克松是一种耐受性良好,有效的治疗选择,用于在癌症和非癌症群体中治疗OIC.
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