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Opioid-Induced Constipation Significant in Pain Patients


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Patients surveyed about laxative use, number of bowel movements

TUESDAY, March 31, 2015 (HealthDay News) — Opioid-induced constipation (OIC) is significant among noncancer pain patients, according to a study published online March 20 in Pain Medicine.

Karin S. Coyne, Ph.D., M.P.H., from Evidera in Bethesda, Md., and colleagues evaluated patients (62 percent female; 85 percent white) on opioid therapy for at least four weeks for chronic noncancer pain. OIC was assessed using an Internet-based survey at baseline (489 patients) and weeks 2, 4, 6, 8, 12, 16, 20, and 24. Sufficient laxative use (at least one laxative at least four times in past two weeks) and inadequate response (LIR; fewer than three bowel movements or at least one constipation symptom rated moderate or greater) defined 1xLIR, while 2xLIR was defined as sufficient laxative use of at least two laxatives from different drug classes and inadequate response.

The researchers found that at baseline, 27 percent of participants reported no laxative use, 25 percent had insufficient laxative use, and 48 percent had sufficient laxative use. Over the follow-up, 21 to 28 percent of patients had no or insufficient laxative use. At baseline, the prevalence of 1xLIR was 93 percent; it ranged from 59 to 81 percent across follow-up. For 2xLIR, 26 percent met criteria at baseline, while the range during follow-up was 11 to 20 percent.

“OIC among noncancer pain patients is a persistent and significant condition with varying utilization and response to laxatives thus increasing the ongoing burden of chronic pain,” the authors write.

Three authors disclosed financial ties to AstraZeneca, which funded the study. Other authors disclosed ties to Evidera and United BioSource Corporation.

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