| Alvimopan for the management of postoperative ileus after bowel resection: characterization of clinical benefit by pooled responder analysis. | |
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MedLine Citation:
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PMID: 20526599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: A pooled post hoc responder analysis was performed to assess the clinical benefit of alvimopan, a peripherally acting mu-opioid receptor (PAM-OR) antagonist, for the management of postoperative ileus after bowel resection. METHODS: Adult patients who underwent laparotomy for bowel resection scheduled for opioid-based intravenous patient-controlled analgesia received oral alvimopan or placebo preoperatively and twice daily postoperatively until hospital discharge or for 7 postoperative days. The proportion of responders and numbers needed to treat (NNT) were examined on postoperative days (POD) 3-8 for GI-2 recovery (first bowel movement, toleration of solid food) and hospital discharge order (DCO) written. RESULTS: Alvimopan significantly increased the proportion of patients with GI-2 recovery and DCO written by each POD (P < 0.001 for all). More patients who received alvimopan achieved GI-2 recovery on or before POD 5 (alvimopan, 80%; placebo, 66%) and DCO written before POD 7 (alvimopan, 87%; placebo, 72%), with corresponding NNTs equal to 7. CONCLUSIONS: On each POD analyzed, alvimopan significantly increased the proportion of patients who achieved GI-2 recovery and DCO written versus placebo and was associated with relatively low NNTs. The results of these analyses provide additional characterization and support for the overall clinical benefit of alvimopan in patients undergoing bowel resection. |
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Authors:
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Kirk Ludwig; Eugene R Viscusi; Bruce G Wolff; Conor P Delaney; Anthony Senagore; Lee Techner |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: World journal of surgery Volume: 34 ISSN: 1432-2323 ISO Abbreviation: World J Surg Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-09 Completed Date: 2010-12-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 2185-90 Citation Subset: IM |
Affiliation:
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Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA. kludwig@mcw.edu |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00205842; NCT00388258; NCT00388401; NCT00388479 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Colonic Neoplasms / surgery Digestive System Surgical Procedures / adverse effects* Diverticulosis, Colonic / surgery Female Humans Ileus / drug therapy* Intestines / surgery* Length of Stay Male Middle Aged Piperidines / therapeutic use* Postoperative Complications / surgery Receptors, Opioid, mu / antagonists & inhibitors* Recovery of Function Rectal Neoplasms / surgery Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Piperidines; 0/Receptors, Opioid, mu; 0/alvimopan |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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