Opioid therapy duration before naldemedine treatment is a significant independent risk of diarrhea: a retrospective cohort study

• Material Type: 博士論文
• Title: Opioid therapy duration before naldemedine treatment is a significant independent risk of diarrhea: a retrospective cohort study
• Author/Editor: Okamoto, Akiharu
• Author Heading: Okamoto, Akiharu
• Publication, Distribution, etc.: 三重大学
• Publication Date: 2022-03-25
• Publication Date (W3CDTF): 2022-03-25
• Degree grantor/type: 三重大学
• Date Granted: 2022-03-25
• Date Granted (W3CDTF): 2022-03-25
• Dissertation Number: 甲医学第2106号
• Degree Type: 博士(医学)
• Conferring No. (Dissertation): 甲医学第2106号
• Text Language Code: eng
• Alias of Author: オカモト, アキハル; 岡本, 明大
• Subject Heading: Naldemedine; Diarrhea; Opioid-induced constipation; Peripherally acting μ-opioid receptor antagonist
• Target Audience: 一般
• Note (General): application/pdf; Background: The most common adverse event (AE) associated with opioid analgesics is opioid-induced constipation (OIC). Naldemedine (NAL) is widely used for the treatment of OIC. However, diarrhea has been reported as the most common treatment-emergent AE of NAL, and little is known about the risk factors associated with the development of diarrhea during NAL administration. This study examined the risk factors for NAL-induced diarrhea via a retrospective chart review of hospitalized patients.Methods: The data of 101 hospitalized adult patients who received NAL for the first time for the treatment of OIC at Mie University Hospital between June 2017 and December 2018 were extracted from electronic medical records. According to the inclusion and exclusion criteria, 70 of the 101 patients were enrolled in this study. Diarrhea was defined as “diarrhea” on the medical record within 2 weeks of NAL administration. Univariate and multivariate analyses were performed to identify risk factors for the development of diarrhea in patients receiving NAL.Results: Twenty-two of the 70 patients enrolled (31%) developed diarrhea within 2 weeks of NAL administration. The median duration (range) of NAL treatment before diarrhea onset was 3 (1–12) days. Patients with diarrhea had a significantly longer duration of opioid therapy before NAL administration than patients without diarrhea (P=0.002). Multivariate logistic regression analysis indicated that the independent risk factors for the development of NALinduced diarrhea were NAL administration after more than 17 days of opioid therapy (odds ratio [OR]=7.539; P= 0.016) and pancreatic cancer (OR=6.217; P=0.025). In fact, the incidence of diarrhea in patients who were administered NAL within a day of opioid therapy was significantly lower than that in patients who were administered NAL after more than 17 days of opioid therapy (13% vs. 54%, P=0.030).Conclusions: These results suggested that a prolonged duration of opioid therapy prior to NAL initiation is associated with increased incidence of diarrhea.; 本文/Department of Pharmacy, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan; 8p
• DOI: info:doi/10.1186/s40780-020-00187-3; https://doi.org/info:doi/10.1186/s40780-020-00187-3
• Persistent ID (NDL): info:ndljp/pid/12313680; https://dl.ndl.go.jp/pid/12313680
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2022-08-08T06:02:54+09:00
• Date Created (W3CDTF): 2022-07-20
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://hdl.handle.net/10076/00020574; https://mie-u.repo.nii.ac.jp/records/14956
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp