A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with Cancer
Abstract Introduction Opioid-induced constipation (OIC) is one of the most common side effects in patients with cancer treated with opioid analgesics. The actual use of laxatives for OIC in Japan remains unelucidated. This study aimed to investigate the real-world patterns of laxative use for patien...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-05-01
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| Series: | Pain and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40122-023-00520-2 |
| _version_ | 1797795839990562816 |
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| author | Takahiro Higashibata Takaomi Kessoku Yasuhide Morioka Yuichi Koretaka Hirokazu Mishima Hidetoshi Shibahara Yuriko Masuda Yasushi Ichikawa Atsushi Nakajima Takayuki Hisanaga |
| author_facet | Takahiro Higashibata Takaomi Kessoku Yasuhide Morioka Yuichi Koretaka Hirokazu Mishima Hidetoshi Shibahara Yuriko Masuda Yasushi Ichikawa Atsushi Nakajima Takayuki Hisanaga |
| author_sort | Takahiro Higashibata |
| collection | DOAJ |
| description | Abstract Introduction Opioid-induced constipation (OIC) is one of the most common side effects in patients with cancer treated with opioid analgesics. The actual use of laxatives for OIC in Japan remains unelucidated. This study aimed to investigate the real-world patterns of laxative use for patients with cancer who newly initiated opioid analgesic therapy. Methods We used a Japanese nationwide hospital claims database (January 2018–December 2019). Patients with cancer newly receiving opioid analgesic therapy were included and classified on the basis of opioid classes (weak or strong) and route of administration (oral or transdermal) at initiation. The patients were divided into two groups on the basis of whether they received early medication (starting laxatives within 3 days after initiating opioid analgesic therapy), and patterns of laxative use were analyzed. Results There were 26,939 eligible patients, with 50.7% of them initiated with strong opioids. The proportion of patients who received early medication was 25.0% for weak opioids and 57.3% for strong opioids. Osmotic laxatives were most frequently used as first-line therapy in the early medication group (oral weak opioids: 12.3%, oral strong opioids: 29.4%, transdermal strong opioids: 12.8%). Stimulant laxatives were frequently used as first-line therapy, to the same extent or more than osmotic laxatives in the non-early medication group (oral weak opioids: 13.7%, oral strong opioids: 7.7%, transdermal strong opioids: 15.1%). Peripherally acting μ-opioid receptor antagonists were the second most frequently used in the early medication group for those on oral strong opioids (9.4%). Conclusion This study demonstrated for the first time that the patterns of laxative use for OIC in Japanese patients with cancer were different, depending on the opioid types at initiation and the timing of laxative medication. |
| first_indexed | 2024-03-13T03:24:04Z |
| format | Article |
| id | doaj.art-4a8104deabbd49128e6b7172e93e6944 |
| institution | Directory Open Access Journal |
| issn | 2193-8237 2193-651X |
| language | English |
| last_indexed | 2024-03-13T03:24:04Z |
| publishDate | 2023-05-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Pain and Therapy |
| spelling | doaj.art-4a8104deabbd49128e6b7172e93e69442023-06-25T11:08:14ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2023-05-01124993100310.1007/s40122-023-00520-2A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with CancerTakahiro Higashibata0Takaomi Kessoku1Yasuhide Morioka2Yuichi Koretaka3Hirokazu Mishima4Hidetoshi Shibahara5Yuriko Masuda6Yasushi Ichikawa7Atsushi Nakajima8Takayuki Hisanaga9Department of Palliative and Supportive Care, University of Tsukuba HospitalDepartment of Palliative Medicine, International University of Health and Welfare Narita HospitalMedical Affairs Department, Shionogi & Co., Ltd.Data Science Department, Shionogi & Co., LtdMedical Affairs Department, Shionogi & Co., Ltd.CRECON Medical Assessment Inc.CRECON Medical Assessment Inc.Department of Oncology, Yokohama City University School of MedicineDepartment of Gastroenterology and Hepatology, Yokohama City University School of MedicineDepartment of Palliative Medicine, Tsukuba Medical Center HospitalAbstract Introduction Opioid-induced constipation (OIC) is one of the most common side effects in patients with cancer treated with opioid analgesics. The actual use of laxatives for OIC in Japan remains unelucidated. This study aimed to investigate the real-world patterns of laxative use for patients with cancer who newly initiated opioid analgesic therapy. Methods We used a Japanese nationwide hospital claims database (January 2018–December 2019). Patients with cancer newly receiving opioid analgesic therapy were included and classified on the basis of opioid classes (weak or strong) and route of administration (oral or transdermal) at initiation. The patients were divided into two groups on the basis of whether they received early medication (starting laxatives within 3 days after initiating opioid analgesic therapy), and patterns of laxative use were analyzed. Results There were 26,939 eligible patients, with 50.7% of them initiated with strong opioids. The proportion of patients who received early medication was 25.0% for weak opioids and 57.3% for strong opioids. Osmotic laxatives were most frequently used as first-line therapy in the early medication group (oral weak opioids: 12.3%, oral strong opioids: 29.4%, transdermal strong opioids: 12.8%). Stimulant laxatives were frequently used as first-line therapy, to the same extent or more than osmotic laxatives in the non-early medication group (oral weak opioids: 13.7%, oral strong opioids: 7.7%, transdermal strong opioids: 15.1%). Peripherally acting μ-opioid receptor antagonists were the second most frequently used in the early medication group for those on oral strong opioids (9.4%). Conclusion This study demonstrated for the first time that the patterns of laxative use for OIC in Japanese patients with cancer were different, depending on the opioid types at initiation and the timing of laxative medication.https://doi.org/10.1007/s40122-023-00520-2CancerLaxativeOpioid-induced constipationPAMORA |
| spellingShingle | Takahiro Higashibata Takaomi Kessoku Yasuhide Morioka Yuichi Koretaka Hirokazu Mishima Hidetoshi Shibahara Yuriko Masuda Yasushi Ichikawa Atsushi Nakajima Takayuki Hisanaga A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with Cancer Pain and Therapy Cancer Laxative Opioid-induced constipation PAMORA |
| title | A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with Cancer |
| title_full | A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with Cancer |
| title_fullStr | A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with Cancer |
| title_full_unstemmed | A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with Cancer |
| title_short | A Nationwide Hospital Claims Database Analysis of Real-World Patterns of Laxative Use for Opioid-Induced Constipation in Japanese Patients with Cancer |
| title_sort | nationwide hospital claims database analysis of real world patterns of laxative use for opioid induced constipation in japanese patients with cancer |
| topic | Cancer Laxative Opioid-induced constipation PAMORA |
| url | https://doi.org/10.1007/s40122-023-00520-2 |
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