Evidence map›Paper›PMID 30922276›Full record

Observational studyBMC palliative care2019

Optimal treatment of opioid induced constipation in daily clinical practice - an observational study.

Elisabeth C W Neefjes, Hanneke van der Wijngaart, Maurice J D L van der Vorst, Diederik Ten Oever, Hans J van der Vliet, Aart Beeker, Christiaan A Rhodius, Hendrik P van den Berg, Johannes Berkhof, Henk M W Verheul

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC palliative care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01955213 (Clinical Evaluation of the Efficacy of Methylnaltrexone in Resolving Constipation Induced by Different Opioid Subtypes, Combined With Laboratory Analysis of Immunomodulatory and Antiangiogenic Effects of Methylnaltrexone), which is not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
2.1field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01955213 terminatednot on this map

Clinical Evaluation of the Efficacy of Methylnaltrexone in Resolving Constipation Induced by Different Opioid Subtypes, Combined With Laboratory Analysis of Immunomodulatory and Antiangiogenic Effects of Methylnaltrexone

TypeobservationalSponsorAmsterdam UMC, location VUmcRan2012 to 2017Enrolled7ConditionsConstipationArmsmethylnaltrexone
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. The P2YBMC gastroenterology · 2024
    Article
  5. Review
  6. Article
  7. Risk and main contributing factors for constipation in patients with gastrointestinal cancer: a multicenter cross-sectional study in China.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Elisabeth C W NeefjesDepartment of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Hanneke van der WijngaartDepartment of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Maurice J D L van der VorstDepartment of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Diederik Ten OeverDepartment of Internal Medicine, Medical Center Alkmaar, Alkmaar, the Netherlands.
Hans J van der VlietDepartment of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Aart BeekerDepartment of Internal Medicine, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Christiaan A RhodiusDepartment of Internal Medicine, Spaarne Gasthuis, Hoofddorp, the Netherlands.
Hendrik P van den BergDepartment of Internal Medicine, Tergooi, Hilversum, the Netherlands.
Johannes BerkhofDepartment of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands.
Henk M W VerheulDepartment of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, De Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands. h.verheul@vumc.nl.
Cancer Center AmsterdamMedisch Centrum Alkmaar · NLSpaarne Ziekenhuis · NLAmsterdam University Medical Centers · NLTergooi · NL

Funding

Fonds NutsOhra 1201-038
6 · The paper itself

Abstract

backgroundOpioids are prescribed in over 40% of patients with advanced cancer, but side effects occur frequently. In this study we evaluated the development and treatment of opioid induced constipation (OIC), and OIC resolving effect of methylnaltrexone for different opioid subtypes in daily clinical practice.

methodsPatients with cancer using opioids were included in a retrospective chart analysis. Baseline characteristics, data on opioid use, laxative use, and OIC were collected. Patients with OIC who were prescribed methylnaltrexone, were included in a prospective observational trial (NCT01955213).

resultsThirty-nine of 327 patients (pts) with cancer who were treated with opioids suffered from OIC (overall prevalence 12%; 95%-CI: 8-15%). The prevalence of OIC was similar in patients treated with oxycodone or fentanyl (12 of 81 pts. vs. 18 of 110 pts., RR 0.9; 95%CI 0.4-2.0). The morphine equivalent daily dose did not significantly differ between opioid subtypes (fentanyl 89 mg (IQR 60-180) vs. oxycodone 40 mg (40-80), P = 0.231). Twenty-two individual patients (7%) were admitted for OIC. Most effective laxatives in admitted patients were enemas, methylnaltrexone, or 4-l polyethylene-glycol solution. In the prospective observational study, the effect of methylnaltrexone could be evaluated in 23 patients. Eleven patients achieved the primary endpoint of ≥2 laxation responses out of the first four doses methylnaltrexone, independent of opioid subtype.

conclusionsOIC is a burdensome clinical problem independent of opioid subtype. Timely intensification of prophylactic laxative treatment, especially when opioid doses increase, may help to prevent OIC. Clinically overt OIC requires a more intensive laxative regimen with for example methylnaltrexone.

trial registrationNCT01955213 .

Indexed as

AgedAnalgesics, OpioidConstipationFemaleFentanylHumansLaxativesMaleMiddle AgedNaltrexoneNarcotic AntagonistsNeoplasmsOxycodonePain ManagementProspective StudiesQuaternary Ammonium CompoundsAnalgesics, OpioidFentanylLaxativesmethylnaltrexoneNaltrexoneNarcotic AntagonistsOxycodoneQuaternary Ammonium CompoundsConstipationLaxativesMethylnaltrexoneNeoplasmsOpioidPain management

Identifiers

PMID30922276
PMCPMC6439982
OpenAlexW2937143615

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.