Karin S Coyne1, Mary Kay Margolis1, Karen Yeomans2, Frederic R King3, Soheil Chavoshi4, Krista A Payne2, Robert J LoCasale5. 1. Outcomes Research, Evidera, Bethesda, Maryland, USA. 2. Value Demonstration, United BioSource Corporation (UBC) An Express Scripts Company, Montreal, Quebec, Canada. 3. Global Payer Evidence and Pricing in Global Medicines and Development, AstraZeneca, Gaithersburg, Maryland, USA. 4. Medical Evidence in Global Medical Affairs, AstraZeneca, Gaithersburg, Maryland, USA. 5. Medical Evidence & Observational Research in Global Medical Affairs AstraZeneca, Gaithersburg, Maryland, USA.
Abstract
PURPOSE: Estimate rate of laxative inadequate response (LIR) over time among patients with chronic noncancer pain with opioid-induced constipation (OIC). METHODS: A prospective longitudinal study was conducted in United States, Canada, Germany, and United Kingdom. Patients on opioid therapy for ≥4 weeks for chronic noncancer pain and OIC completed an Internet-based survey at Baseline and Weeks 2, 4, 6, 8, 12, 16, 20, and 24. 1xLIR was defined as sufficient laxative use (≥1 laxative ≥ 4 times in past 2 weeks) and inadequate response (<3 bowel movements or ≥ 1 constipation symptom rated Moderate or greater). 2xLIR was sufficient laxative use of ≥2 laxatives from different drug classes and inadequate response. Descriptive statistics and logistic regressions were performed. RESULTS: 489 patients (62% female; 85% white) completed Baseline; 27% reported no laxative use; 25% had insufficient laxative use; 48% had sufficient laxative use. During follow-up, 21-28% of patients had no or insufficient laxative use. Prevalence of 1xLIR was 93% at Baseline and ranged from 59-81% across follow-up; 26% met criteria for 2xLIR (follow-up range: 11-20%). CONCLUSIONS: OIC among noncancer pain patients is a persistent and significant condition with varying utilization and response to laxatives thus increasing the ongoing burden of chronic pain.
PURPOSE: Estimate rate of laxative inadequate response (LIR) over time among patients with chronic noncancer pain with opioid-induced constipation (OIC). METHODS: A prospective longitudinal study was conducted in United States, Canada, Germany, and United Kingdom. Patients on opioid therapy for ≥4 weeks for chronic noncancer pain and OIC completed an Internet-based survey at Baseline and Weeks 2, 4, 6, 8, 12, 16, 20, and 24. 1xLIR was defined as sufficient laxative use (≥1 laxative ≥ 4 times in past 2 weeks) and inadequate response (<3 bowel movements or ≥ 1 constipation symptom rated Moderate or greater). 2xLIR was sufficient laxative use of ≥2 laxatives from different drug classes and inadequate response. Descriptive statistics and logistic regressions were performed. RESULTS: 489 patients (62% female; 85% white) completed Baseline; 27% reported no laxative use; 25% had insufficient laxative use; 48% had sufficient laxative use. During follow-up, 21-28% of patients had no or insufficient laxative use. Prevalence of 1xLIR was 93% at Baseline and ranged from 59-81% across follow-up; 26% met criteria for 2xLIR (follow-up range: 11-20%). CONCLUSIONS: OIC among noncancer painpatients is a persistent and significant condition with varying utilization and response to laxatives thus increasing the ongoing burden of chronic pain.
Authors: N Katakami; T Harada; T Murata; K Shinozaki; M Tsutsumi; T Yokota; M Arai; Y Tada; M Narabayashi; N Boku Journal: Ann Oncol Date: 2018-04-18 Impact factor: 32.976
Authors: Jan Tack; Jaakko Lappalainen; Ulysses Diva; Raj Tummala; Mark Sostek Journal: United European Gastroenterol J Date: 2015-10 Impact factor: 4.623
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