Joshua D Belle1, Aydin Pooli2, Dimitry Oleynikov3, Christopher M Deibert2. 1. Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, 68198, USA. Joshua.belle@unmc.edu. 2. Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, 68198, USA. 3. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Abstract
PURPOSE: Alvimopan (Entereg), a peripherally acting opioid receptor antagonist, is effective in reducing the rate of postoperative ileus and length of hospital stay in patients undergoing colorectal surgery, and is now approved for use after radical cystectomy (RC). Using data from Vizient (formerly University Health System Consortium), we assessed the utilization of alvimopan and its effect on perioperative factors after RC. METHODS: The Vizient database, contributed to by over 200 US academic hospitals, was evaluated from 2014 to 2016. Patients who had undergone radical cystectomy were included. Alvimopan exposure and postoperative outcomes were collected. RESULTS: 7472 patients underwent cystectomy in the 3 years examined, with 3391 (45.4%) patients receiving alvimopan over this time period. The use of alvimopan increased from 35 to 59%. The receipt of alvimopan was associated with a decrease in perioperative morbidity (10.53% vs 19.23%, p = 0.027). CONCLUSION: This study, the largest to examine the real-world utilization of alvimopan since FDA approval for RC, shows that alvimopan utilization has increased substantially and is associated with reduced perioperative morbidity in patients undergoing cystectomy.
PURPOSE:Alvimopan (Entereg), a peripherally acting opioid receptor antagonist, is effective in reducing the rate of postoperative ileus and length of hospital stay in patients undergoing colorectal surgery, and is now approved for use after radical cystectomy (RC). Using data from Vizient (formerly University Health System Consortium), we assessed the utilization of alvimopan and its effect on perioperative factors after RC. METHODS: The Vizient database, contributed to by over 200 US academic hospitals, was evaluated from 2014 to 2016. Patients who had undergone radical cystectomy were included. Alvimopan exposure and postoperative outcomes were collected. RESULTS: 7472 patients underwent cystectomy in the 3 years examined, with 3391 (45.4%) patients receiving alvimopan over this time period. The use of alvimopan increased from 35 to 59%. The receipt of alvimopan was associated with a decrease in perioperative morbidity (10.53% vs 19.23%, p = 0.027). CONCLUSION: This study, the largest to examine the real-world utilization of alvimopan since FDA approval for RC, shows that alvimopan utilization has increased substantially and is associated with reduced perioperative morbidity in patients undergoing cystectomy.
Authors: Justin T Brady; Eslam M G Dosokey; Benjamin P Crawshaw; Scott R Steele; Conor P Delaney Journal: Expert Rev Gastroenterol Hepatol Date: 2015-10-21 Impact factor: 3.869
Authors: Cheryl T Lee; Sam S Chang; Ashish M Kamat; Gilad Amiel; Timothy L Beard; Amr Fergany; R Jeffrey Karnes; Andrea Kurz; Venu Menon; Wade J Sexton; Joel W Slaton; Robert S Svatek; Shandra S Wilson; Lee Techner; Richard Bihrle; Gary D Steinberg; Michael Koch Journal: Eur Urol Date: 2014-02-26 Impact factor: 20.096
Authors: Ahmad Shabsigh; Ruslan Korets; Kinjal C Vora; Christine M Brooks; Angel M Cronin; Caroline Savage; Ganesh Raj; Bernard H Bochner; Guido Dalbagni; Harry W Herr; S Machele Donat Journal: Eur Urol Date: 2008-07-18 Impact factor: 20.096
Authors: Marcus L Quek; John P Stein; Siamak Daneshmand; Gus Miranda; Duraiyah Thangathurai; Peter Roffey; Eila C Skinner; Gary Lieskovsky; Donald G Skinner Journal: J Urol Date: 2006-03 Impact factor: 7.450