scholarly journals Effectiveness of Naloxegol in Patients With Cancer Pain Suffering From Opioid-Induced Constipation

2021 ◽  
Author(s):  
Antoine Lemaire ◽  
Yoann Pointreau ◽  
Bérengère Narciso ◽  
François-Xavier Piloquet ◽  
Viorica Braniste ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Real Life ◽  
Oral Morphine ◽  
Inadequate Response ◽  
Once Daily ◽  
Patients With Cancer ◽  
Pain Patients

Abstract Purpose Naloxegol, an oral once-daily peripherally acting mu-opioid receptor antagonist, is indicated for the treatment of opioid-induced constipation (OIC) with inadequate response to laxative(s), in cancer and non-cancer patients. This study mainly aimed to assess in real-life conditions the efficacy and safety of naloxegol in cancer pain patients, and the evolution of their quality of life. Methods A non-interventional, 4-week follow-up study was conducted in 24 French oncology and pain centers between 2018 and 2019. Eligible patients were aged ≥ 18 years, treated with opioids for cancer-pain, and started naloxegol for OIC with inadequate response to laxatives. The rate of the response to naloxegol (primary criterion) was assessed at W4. The evolution of quality of life was measured using the Patient Assessment of Constipation Quality of Life (PAC-QOL). Results A total of 124 patients were included (mean age: 62 ± 12 years; ECOG ≤ 2: 79%; primary cancer: lung 18%, breast 16%, prostate 11%, head and neck 9%, digestive 9%...; metastatic stage: 80%). At inclusion, the median opioid dosage was 60 mg of oral-morphine or equivalent. At W4, the response rate was 73.4% (95% CI [63.7%-83.2%]) and 62.9% (95% CI [51.5%-74.2%]) of patients had a clinically relevant change in quality of life (decrease in PAC-QOL score ≥ 0.5 point). Adverse events related to naloxegol were reported in 8% of patients (7% with gastrointestinal events; one serious diarrhea). Conclusion This real-world study shows that naloxegol is effective and well tolerated in cancer pain patients with OIC and that their quality of life improves under treatment.

scholarly journals Efficacy of naloxegol on symptoms and quality of life related to opioid-induced constipation in patients with cancer: a 3-month follow-up analysis

2020 ◽  
pp. bmjspcare-2020-002249
Author(s):  
Manuel Cobo Dols ◽  
Carmen Beato Zambrano ◽  
Luis Cabezón Gutiérrez ◽  
Rodolfo Chicas Sett ◽  
María Isabel Blancas López-Barajas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Karnofsky Performance Status ◽  
Moderate Intensity ◽  
Life Questionnaire ◽  
Inadequate Response ◽  
Patient Assessment ◽  
Patients With Cancer ◽  
Bowel Movements

ObjectivesOpioid-induced constipation (OIC) can affect up to 63% of all patients with cancer. The objectives of this study were to assess quality of life as well as efficacy and safety of naloxegol, in patients with cancer with OIC.MethodsAn observational study was made of a cohort of patients with cancer and with OIC exhibiting an inadequate response to laxatives and treated with naloxegol. The sample consisted of adult outpatients with a Karnofsky performance status score ≥50. The Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) and the Patient Assessment of Constipation Symptoms (PAC-SYM) were applied for 3 months.ResultsA total of 126 patients (58.2% males) with a mean age of 61.3 years (range 34–89) were included. Clinically relevant improvements (>0.5 points) were recorded in the PAC-QOL and PAC-SYM questionnaires (p<0.0001) from 15 days of treatment. The number of days a week with complete spontaneous bowel movements increased significantly (p<0.0001) from 2.4 to 4.6 on day 15, 4.7 after 1 month and 5 after 3 months. Pain control significantly improved (p<0.0001) during follow-up. A total of 13.5% of the patients (17/126) presented some gastrointestinal adverse reaction, mostly of mild (62.5%) or moderate intensity (25%).ConclusionsClinically relevant improvements in OIC-related quality of life, number of bowel movements and constipation-related symptoms were recorded as early as after 15 days of treatment with naloxegol in patients with cancer and OIC, with a good safety profile.

scholarly journals The Efficacy and Safety of Transcutaneous Acupoint Interferential Current Stimulation for Cancer Pain Patients With Opioid-Induced Constipation: A Prospective Randomized Controlled Study

2017 ◽  
Vol 17 (2) ◽  
pp. 437-443 ◽  
Author(s):  
Hua-dong Zhu ◽  
Zhen Gong ◽  
Bing-wei Hu ◽  
Qiao-ling Wei ◽  
Jun Kong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Controlled Study ◽  
Control Group ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Interferential Current ◽  
Pain Patients

Introduction. Opioid-induced constipation (OIC) is a principal complication secondary to analgesic therapy for cancer pain patients who suffer moderate to severe pain. In this study, we observe the efficacy and safety of transcutaneous acupoint interferential current (IFC) stimulation in those patients with OIC. Methods. A total of 198 patients were randomly allocated to the IFC group and control group in a 1:1 ratio. Finally, 98 patients in the IFC group received 14 sessions administered over 2 weeks, whereas 100 patients in the control group took lactulose orally during the same period. Observation items were documented at management stage and at follow-up stage according to Cleveland Constipation Scales (CCS), pain Numeric Rating Scales (NRS) and Patient Assessment of Constipation Quality of Life (PAC-QoL). Results. The total curative effects of the IFC group and the control group were indistinguishable (76.5% vs 70.0%, P = .299). Regarding CCS and PAC-QoL scores, no significant difference was observed between the 2 groups during the management time and at the follow-up stage of week 3 ( P > .05, respectively), but groups were distinguished at the follow-up stage of week 4 ( P < .001 and P = .031, respectively). The pain NRS decreased significantly at management stage week 2 and follow-up stage week 3 and week 4 ( P = .013, P = .041, P = .011, respectively). Conclusions. Transcutaneous acupoint IFC therapy over acupoints of Tianshu (ST25) and Zhongwan (RN12) may improve constipation and quality of life in cancer patients receiving opiates; further studies are worthwhile.

Correlational study of different analgesic programs on patients' quality of life, mood, and dignity.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24139-e24139
Author(s):  
Long Wang ◽  
Xue Zhang ◽  
Zhimin Liu ◽  
Mei Shan ◽  
Xinyan Hu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sustained Release ◽  
Cancer Pain ◽  
Life Assessment ◽  
Patients With Cancer ◽  
Group A ◽  
Group B ◽  
Strong Opioids ◽  
Pain Patients

e24139 Background: To evaluate the effects between oral sustained release opioids and other analgesic drugs on the quality of life, mood and dignity of patients with cancer pain. Methods: Participants were cancer patients with cancer pain recruited from a tertiary cancer hospital in North China. Patients were divided into group A (oral sustained-release strong opioids,) and group B (non-sustained release strong opioid analgesia, as tramadol, oxycodone aminophenol, non-steroidal analgesia, etc.) to assess their quality of life, mood and dignity. Data were collected using the Patient Dignity Inventory, the MD Anderson Symptom Inventory–Chinese, the distress thermometer, the Hospital Anxiety and Depression Scale, and the 30-question core Quality of Life Questionnaire from the European Organisation for Research and Treatment of Cancer, and were analyzed using quantitative methods. Results: The study included 297 cancer pain patients, including 172 males and 125 females, with a median age of 58 years, most of whom were lung cancer (n = 88), esophageal/gastric cancer (n = 63) and colorectal cancer (n = 52). Patients in group A(n = 224) had better pain control (P < 0.001), symptom burden (P < 0.001), psychological distress (P < 0.001), anxiety (P = 0.001) and Sense of dignity (P = 0.014) than those in group B(n = 73). In terms of quality of life assessment, patients in group A were more likely to suffer from nausea and vomiting (P = 0.003), and patients in group A were better than those in group B (Ps < 0.05), except for the similarity of social cognitive function, decreased appetite, diarrhea and constipation. Conclusions: The analgesic program with oral sustained - release strong opioids for cancer pain patients not only has better analgesic effect than other programs, but also has obvious advantages in physical symptoms, psychological emotion, sense of dignity and overall quality of life.

Pain management

2020 ◽  
pp. 629-633
Author(s):  
Marie Fallon
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Pain Relief ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Daily Functioning ◽  
Opioid Analgesia ◽  
Patients With Cancer ◽  
Good Pain Relief

Pain occurs in more than 50% of patients with advanced disease, interferes with daily functioning and quality of life, and is very often undertreated. Patients can find it difficult to articulate the character of their pains, but it is important to determine whether it is somatic, neuropathic, or visceral since this has important implications for management. For most patients with cancer pain, a three-step approach combining simple or opioid analgesia (depending on severity) along with an adjuvant analgesic (depending on cause) will result in good pain relief, but the challenge is to achieve good pain relief without unacceptable adverse effects.

scholarly journals Managing Pain in Patients With Cancer: The Chinese Good Pain Management Experience

2017 ◽  
Vol 3 (5) ◽  
pp. 583-595 ◽  
Author(s):  
Shi-Ying Yu ◽  
Jie-Jun Wang ◽  
Yu-guang Huang ◽  
Bing Hu ◽  
Kun Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
High Standard ◽  
Management Training ◽  
Drug Dose ◽  
Dose Titration ◽  
Patients With Cancer ◽  
Opioid Drugs

Purpose The number of cancer cases in China has increased rapidly from 2.1 million in 2000 to 4.3 million in 2015. As a consequence, pain management as an integral part of cancer treatment became an important health care issue. In March 2011, the Good Pain Management (GPM) program was launched to standardize the treatment of cancer pain and improve the quality of life for patients with cancer. With this work, we will describe the GPM program, its implementation experience, and highlight key lessons that can improve pain management for patients with cancer. Methods We describe procedures for the selection, implementation, and assessment procedures for model cancer wards. We analyzed published results in areas of staff training and patient education, pain management in practice, analgesic drugs administration, and patient follow-up and satisfaction. Results Pain management training enabled medical staff to accurately assess the level of pain and to provide effective pain relief through timely dispensation of medication. Patients with good knowledge of treatment of pain were able to overcome their aversion to opioid drugs and cooperate with nursing staff on pain assessment to achieve effective drug dose titration. Consumption of strong opioid drugs increased significantly; however, there was no change for weaker opioids. Higher pain remission rates were achieved for patients with moderate-to-severe pain levels. Proper patient follow-up after discharge enabled improved outcomes to be maintained. Conclusion The GPM program has instituted a consistent and high standard of care for pain management at cancer wards and improved the quality of life for patients with cancer.

scholarly journals Application of quality control circle in the treatment of moderate cancer pain in inpatients

2020 ◽  
Vol 50 (5) ◽  
pp. 581-585
Author(s):  
Yehuan Liu ◽  
Beibei Lin
Keyword(s):  
Quality Of Life ◽  
Quality Control ◽  
Cancer Pain ◽  
Pain Control ◽  
Management Tool ◽  
Control Group ◽  
Observation Group ◽  
Patients With Cancer ◽  
Significant Difference

Abstract Context Pain is one of the most common and intolerable symptoms in cancer patients. But cancer pain control is still negative in China. Objectives This paper explores the application of quality control circle in the treatment of cancer pain in inpatients to improve the quality of life of patients with cancer pain. Method Established a quality control circle group to analyze the current status of cancer pain control in inpatients with moderate cancer pain, set goals, formulate corresponding countermeasures and implement and review them in stages. The plan-do-check-act method was cyclically applied. The Brief Pain Inventory was used to evaluate the cancer pain status of patients with cancer pain hospitalized before (January to April 2016) and after (September to December 2016) the implementation of quality control circle activities. Results The pain control effect of the observation group was significantly better than that of the control group. The mean (standard deviation) of pain severity and pain interference in the observation group were significantly lower than those in the control group (6.21 [2.86] vs 4.31 [2.25], 10.54 [4.10] vs 7.25 [3.77]). There was significant difference after the implementation of quality control circle (P &lt; 0.01). Conclusion Quality control circle activities are used to manage patients with cancer pain, to improve the situation of pain control and to improve the quality of life of patients. This management tool and method is worthy of clinical promotion and application.

scholarly journals Observation of the Improvement in Nocturnal Asthma Symptoms with Administration of Once Daily Sustained Released Theophylline

2018 ◽  
Vol 9 (2) ◽  
pp. 74-77
Author(s):  
Mesbahul Karim Ruble ◽  
AKM Rafiqul Bari ◽  
Amar Biswas ◽  
Md Khairul Anam ◽  
Mahbub E Khuda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sustained Release ◽  
Pulmonary Function Tests ◽  
Persistent Asthma ◽  
Nocturnal Asthma ◽  
Once Daily ◽  
Asthma Symptoms ◽  
Sustained Release Theophylline

Objective: The aims and objective of this study to observe the improvement in Nocturnal Asthma symptoms and Quality of Life (QoL) with administration of once daily sustained release theophylline preparation.Background: Nocturnal symptoms are a common part of the asthma. Nocturnal asthma is defined by a drop in forced expiratory volume in 1 second (FEV1) of at least 15% between bedtime and awakening in patients with clinical and physiologic evidence of asthma, which may include improvement in QoL.Methodology: The patient with Chronic Persistent Asthma, both sex, age >18 to 50 years of age and preferably patients with nocturnal exacerbations were included in the study. All patients were diagnosed on the basis of clinical history, physical examination, chest X-ray and pulmonary function tests, in accordance with the clinical criteria for the diagnosis by the GINA. The recruitment period was between March 2017 and August 2017 Shaheed Suhrawardy Medical College Hospital, Dhaka.Results: It was observed that 65(92.85%) was found exacerbation free night and 5(7.15%) patients were found exacerbation with sustained release Theophylline. There are significantly improved qualities of life between 1st follow up to 2nd follow up, 3rd follow up and 4th follow up p<0.001 which was statistically significant. Spirometry test was gradually improved between 1st visit of FEV1 to 2nd, 3rd and 4th visit of FEV1, (p<0.001) that was statistically significant.Conclusion: Most of the patients were found exacerbation free night. There are significantly improved quality of life between 1st follow up to 2nd follow up, 3rd follow up and 4th follow up in Spirometry test. The value of FEV1 was gradually improve in the lst visit, 2nd, 3rd and 4th visit with sustained release Theophylline.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 74-77

scholarly journals Quality of life in thyroid cancer patients: a literature review

2017 ◽  
Vol 90 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Elena Bãrbuş ◽  
Claudiu Peştean ◽  
Maria Iulia Larg ◽  
Doina Piciu
Keyword(s):  
Quality Of Life ◽  
Thyroid Cancer ◽  
Literature Review ◽  
Psychological Impact ◽  
Solid Base ◽  
Emotional Impact ◽  
Free Access ◽  
Patients With Cancer

Introduction. Quality of life (QoL) has received increasing interest in the last years, especially in patients with cancer. This article aims to analyze a selection of medical research papers regarding the quality of life in patients with thyroid carcinoma. We overviewed the main QoL aspects derived from several studies and highlighted those less researched issues, which could represent a solid base for future clinical studies.Method. We used an integrative selection method of medical literature, choosing mostly "free access" studies, as it was considered that they could be easily viewed, searched and researched including by patients.Results. After an integrative literature review, we selected 16 relevant studies. Patients with thyroid cancer have several factors influencing their QoL, with both physical and psychological impact. The decisive factors are the quality of the surgical act, radioiodine therapy, follow-up using rh-TSH vs. hormonal withdrawal, access to behavioral help and the relationship with their physician.Conclusion. We must understand the emotional impact of the cancer diagnosis on the patient and we must collaborate in order to help the patient restore the psychosomatic balance and to recover the quality of life.

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