2020 Volume 46 Issue 11 Pages 672-678
Countermeasures against side effects (sleepiness, nausea, vomiting, and constipation) are necessary to continue pain treatment using opioids. However, as opioid-induced constipation (OIC) does not develop resistance, we consider OIC countermeasures to be particularly important. Therefore, we retrospectively compared the efficacy of naldemedine (a drug approved for OIC) in 33 patients with that of sennoside (a conventionally used colon stimulant laxative) in 32 patients. The spontaneous bowel movement (SBM) rate (times/day) was investigated 7 days before and after the start of treatment. The SBM responder rate and usage rate of rescue laxatives were examined to compare both drugs. The SBM responder rate is the percentage of patients meeting the following conditions: ①Patients with 3 or more SBMs within 7 days of starting treatment and ②those with an increased SBM rate compared with 7 days before starting treatment. We used the inverse probability of treatment weighting (IPTW) method to compare the efficacy of both drugs. The SBM ratio increased significantly with both naldemedine (before treatment: 0.4, After: 1.3, P < 0.01) and sennoside (before treatment: 0.4, After: 0.9, P < 0.05). The SBM responder rate in the naldemedine group was significantly higher as compared to the sennoside group (using IPTW: 75.8％ vs 56.3％, P < 0.05). The usage rate of rescue laxatives in the naldemedine group was significantly lower as compared to the sennoside group (using IPTW: 24.2％ vs 40.6％, P < 0.01). Our study suggests that naldemedine is clinically effective for treating OIC.
