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纳地美定用于体能状态较差的癌症患者阿片类药物所致便秘的疗效与安全性

Efficacy and Safety of Naldemedine Administration for Opioid-Induced Constipation in Cancer Patients with Poor Performance Status.

作者信息

Fujita Yukiyoshi, Imai Hisao, Hiruta Eriko, Masuno Takashi, Yamazaki Shigeki, Tanaka Hajime, Kamiya Teruhiko, Sandoh Mitsuru, Takei Satoshi, Arai Kazuya, Nishiba Hiromi, Mogi Junnosuke, Koizuka Shiro, Saito Taeko, Obayashi Kyoko, Kaira Kyoichi, Minato Koichi

机构信息

Divisions of Pharmacy, Gunma Prefectural Cancer Center, Ota, Japan.

Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan.

出版信息

J Palliat Med. 2023 Apr;26(4):548-553. doi: 10.1089/jpm.2022.0495. Epub 2023 Mar 27.

Abstract

Constipation is a concern among patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 3 and 4. To assess naldemedine's efficacy and safety in cancer patients on opioids with poor PS. Multicenter, retrospective study. Japanese cancer patients with ECOG performance status 3 or 4 who received naldemedine. Frequency of defecations before/after naldemedine use. Responders were patients whose defecation frequency increased to ≥3 times/week, from baseline ≥1 defecations/week over seven days after naldemedine administration. Seventy-one patients were analyzed; 66.1% were responders (95% confidence interval: 54.5%-76.1%). Defecation frequency increased significantly after naldemedine in the overall population (6 vs. 2,  < 0.0001) and among those who defecated <3 times/week before naldemedine (4.5 vs. 1,  < 0.0001). Diarrhea (38.0%) of all grades was the most common adverse event; 23 (85.2%) events were classified as Grade 1 or 2. Naldemedine is effective and safe among cancer patients with poor PS.

摘要

便秘是东部肿瘤协作组(ECOG)体能状态(PS)为3和4的患者所关注的问题。为评估纳地美定在PS较差的阿片类药物治疗的癌症患者中的疗效和安全性。进行多中心回顾性研究。纳入接受纳地美定治疗的ECOG体能状态为3或4的日本癌症患者。记录使用纳地美定前后的排便频率。应答者为在纳地美定给药7天后排便频率从基线每周≥1次增加至≥每周3次的患者。分析了71例患者;66.1%为应答者(95%置信区间:54.5%-76.1%)。在总体人群中,纳地美定治疗后排便频率显著增加(6次对2次,P<0.0001),在纳地美定治疗前每周排便<3次的患者中也是如此(4.5次对1次,P<0.0001)。所有级别的腹泻(38.0%)是最常见的不良事件;23例(85.2%)事件被分类为1级或2级。纳地美定在PS较差的癌症患者中有效且安全。

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