Opioid-Induced Constipation in Oncological Patients: New Strategies of Management

被引:37
作者
Mesia, Ricard [1 ]
Virizuela Echaburu, Juan Antonio [2 ]
Gomez, Jose [3 ]
Sauri, Tamara [4 ]
Serrano, Gloria [5 ]
Pujol, Eduardo [6 ]
机构
[1] Inst Catalan Oncol, Serv Oncol Med, Badalona, Spain
[2] Hosp Gen Univ Virgen Macarena, Serv Oncol Med, Seville, Spain
[3] Hosp La Fe, Valencia, Spain
[4] Hosp Clin Barcelona, Barcelona, Spain
[5] Hosp Infanta Leonor, Madrid, Spain
[6] Hosp Clin Lozano Blesa, Zaragoza, Spain
关键词
Cancer; Opioid-induced constipation; Opioid analgesics; Pain; Naloxegol; Laxatives; DOUBLE-BLIND; CANCER PAIN; NALOXEGOL; PREVALENCE; IMPACT; METHYLNALTREXONE; PATHOPHYSIOLOGY; RECOMMENDATIONS; DEFINITION; ANTAGONIST;
D O I
10.1007/s11864-019-0686-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Opinion statement Cancer-associated pain has traditionally been treated with opioid analgesics, often in escalating doses. Opioid-induced constipation (OIC) is a common problem associated with chronic use of opioid analgesics. Typical treatment strategies to alleviate constipation are based on dietary changes, exercise, and laxatives. However, laxatives have a nonspecific action and do not target underlying mechanisms of OIC. This article will review prevalent, clinical presentation and recommendations for the treatment of OIC. An independent literature search was carried out by the authors. We reviewed the literature for randomized controlled trials that studied the efficacy of laxatives, naloxone, and naloxegol in treating OIC. Newer strategies addressing the causal pathophysiology of OIC are needed for a more effective assessment and management of OIC. Finally, traditional recommended therapies are appraised and compared with the latest pharmacological developments. Future research should address whether naloxegol is more efficacious by its comparison directly with first-line treatments, including laxatives.
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页数:14
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