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To study if the opioid analgesia is impaired in older population who were given methylnaltrexone for the management of OIC.
Age-related changes in blood-brain barrier permeability may
cause methylnaltrexone's (peripherally acting µ-opioid receptor antagonist)
restricted diffusion and modify opioid-induced central pain-relieving
consequences. As per the results of this study, there is no affect of age on the safety and effectiveness of methylnaltrexone
for opioid-induced constipation (OIC).
To study if the opioid analgesia is impaired in older
population who were given methylnaltrexone for the management of OIC.
Total of 1627 patients (<65 years and ≥65 years)
diagnosed with OIC who used opioids for pain relief and who had terminal
illness or chronic nonmalignant pain were included. Pain intensity scores,
symptoms of opioid withdrawal, adverse events linked with therapy, and
rescue-free laxation (RFL) in 4 hours of therapy were the study endpoints.
All in all, 1323 patients were aged < 65 years in which
908 patients were in methylnaltrexone and 415 on placebo. In the same way, 304
patients were aged ≥ 65 years which 171 patients on methylnaltrexone and 133
patients on placebo.
All the groups had
nonsignificant pain intensity score decreases. No statistical significant
differences were found from starting point of the study in
methylnaltrexone or placebo groups, in the older patients. Pain in the abdomen,
flatulence, and nausea were commonly described adverse events linked with
therapy. Irrespective of age, the adverse events associated with opioid
withdrawal waned with the second dose than the first dose and were similar with
placebo. The RFL response in 4 hours of methylnaltrexone usage increased
significantly in both age groups relative to the placebo.
The use of Methylnaltrexone did not adversely affect opioid
withdrawal effects, pain control , or adverse events while offering effective
RFL, irrespective of age.
Drugs & Aging
The Influence of Age on Central Effects of Methylnaltrexone in Patients with Opioid-Induced Constipation
Solomon S Liao et al.
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