PURPOSE: To understand the relationship between the risk of opioid-related gastrointestinal adverse effects (AEs) and exposure to tapentadol and oxycodone as well as its active metabolite, oxymorphone, using pharmacokinetic/pharmacodynamic models. METHODS: The analysis was based on a study in patients with moderate-to-severe pain following bunionectomy. Population PK modeling was conducted to estimate population PK parameters for tapentadol, oxycodone, and oxymorphone. Time to AEs was analyzed using Cox proportional-hazards models. RESULTS: Risk of nausea, vomiting, and constipation significantly increased with exposure to tapentadol or oxycodone/oxymorphone. However, elevated risk per drug exposure of AEs for tapentadol was ~3-4 times lower than that of oxycodone, while elevated AE risk per drug exposure of oxycodone was ~60 times lower than that for oxymorphone, consistent with reported in vitro receptor binding affinities for these compounds. Simulations show that AE incidence following administration of tapentadol IR is lower than that following oxycodone IR intake within the investigated range of analgesic noninferiority dose ratios. CONCLUSIONS: This PK/PD analysis supports the clinical findings of reduced nausea, vomiting and constipation reported by patients treated with tapentadol, compared to patients treated with oxycodone.
PURPOSE: To understand the relationship between the risk of opioid-related gastrointestinal adverse effects (AEs) and exposure to tapentadol and oxycodone as well as its active metabolite, oxymorphone, using pharmacokinetic/pharmacodynamic models. METHODS: The analysis was based on a study in patients with moderate-to-severe pain following bunionectomy. Population PK modeling was conducted to estimate population PK parameters for tapentadol, oxycodone, and oxymorphone. Time to AEs was analyzed using Cox proportional-hazards models. RESULTS: Risk of nausea, vomiting, and constipation significantly increased with exposure to tapentadol or oxycodone/oxymorphone. However, elevated risk per drug exposure of AEs for tapentadol was ~3-4 times lower than that of oxycodone, while elevated AE risk per drug exposure of oxycodone was ~60 times lower than that for oxymorphone, consistent with reported in vitro receptor binding affinities for these compounds. Simulations show that AE incidence following administration of tapentadol IR is lower than that following oxycodone IR intake within the investigated range of analgesic noninferiority dose ratios. CONCLUSIONS: This PK/PD analysis supports the clinical findings of reduced nausea, vomiting and constipation reported by patients treated with tapentadol, compared to patients treated with oxycodone.
Authors: Donna A Volpe; Grainne A McMahon Tobin; R Daniel Mellon; Aspandiar G Katki; Robert J Parker; Thomas Colatsky; Timothy J Kropp; S Leigh Verbois Journal: Regul Toxicol Pharmacol Date: 2011-01-06 Impact factor: 3.271
Authors: Stephen E Daniels; David Upmalis; Akiko Okamoto; Claudia Lange; Jüergen Häeussler Journal: Curr Med Res Opin Date: 2009-03 Impact factor: 2.580
Authors: Thomas M Tzschentke; Thomas Christoph; Babette Kögel; Klaus Schiene; Hagen-Heinrich Hennies; Werner Englberger; Michael Haurand; Ulrich Jahnel; Thomas I F H Cremers; Elmar Friderichs; Jean De Vry Journal: J Pharmacol Exp Ther Date: 2007-07-26 Impact factor: 4.030
Authors: Gary M Oderda; Qayyim Said; R Scott Evans; Gregory J Stoddard; Jim Lloyd; Kenneth Jackson; Dale Rublee; Matthew H Samore Journal: Ann Pharmacother Date: 2007-03-06 Impact factor: 3.154
Authors: T O'Brien; L L Christrup; A M Drewes; M T Fallon; H G Kress; H J McQuay; G Mikus; B J Morlion; J Perez-Cajaraville; E Pogatzki-Zahn; G Varrassi; J C D Wells Journal: Eur J Pain Date: 2017-01 Impact factor: 3.931