293P 缓释羟考酮/纳洛酮（OXN）用于治疗癌症疼痛（CP）及其对肠道功能、安全性和生活质量（QoL）的影响：系统评价
01 November 2020
Sam H Ahmedzai, Alfredo Covarrubias-Gómez, Gustavo De Simone, Michael Green, Lizanne Langenhoven, Brian Le, Kyung-Hee Lee, Henry Lu, Patricia Neo, Carlos Rodriguez, Karina Rodrigues Subi, Hayati Yaakup, Stanley Ka Tung Yu, Charlotte Minnaert, Yacine Hadjiat
摘要
Background
OXN PR, a fixed dose combination of opioid and peripherally-acting mu-opioid antagonist, offers analgesia while reducing opioid-induced constipation (OIC). Few have studied OXN vs other strong opioids for impact on bowel function, safety and QoL in patients with CP.
Methods
Systematic review of literature from PubMed and EMBASE that evaluated analgesia, bowel function, adverse events (AE) and QoL after OXN PR or oral oxycodone (OXY)/morphine/tapentadol PR, or transdermal fentanyl, in adults with moderate-severe CP. Data for outcomes were extracted from publications or clinical study reports.
Results
4 RCTs (OXN vs OXY) were found; no RCT compared OXN vs other strong opioids. Analgesia and safety were comparable with OXN or OXY, except for nausea that was less frequent with OXN (Odds ratio: 0.51 [0.26, 0.97]). Most AEs related to OXN and OXY were mild-moderate severity; most common were gastrointestinal disorders. Improved bowel function (BFI, PAC-SYM) was observed with OXN vs OXY (Table). QoL was comparable with OXN or OXY (Global health status, mean difference: 0.5 [-4.7, 5.7]).
