Abstract:
BACKGROUND AND AIM:Opioid-induced constipation (OIC) is a frequent adverse event (AE) that impairs patients' quality of life (QOL). Peripherally acting μ-opioid receptor antagonists (PAMORAs) have been recognized as a treatment option for OIC, but the effect consistent across the studies has not been evaluated. METHODS:We conducted a quantitative meta-analysis to explore the efficacy of PAMORA for OIC (registered with PROSPERO: CRD42018085298). We systematically searched randomized controlled trials (RCTs) in Medline, Embase, and Central databases. Change from baseline in spontaneous bowel movements, pooled proportion of responders, QOL, and AEs were calculated and compared with results in placebo cases. RESULTS:We included 31 RCTs with 7849 patients. A meta-analysis revealed that patients under PAMORA therapy had considerably improved spontaneous bowel movement from baseline compared with those given placebo (20 RCTs; mean difference, 1.43; 95% confidence interval [CI], 1.18-1.68; n = 5622) and more responded (21 RCTs; risk ratio [RR], 1.81; 95% CI, 1.55-2.12; n = 4821). Moreover, QOL of patients receiving PAMORA was significantly better (8 RCTs; mean difference, -0.22; 95% CI, -0.28 to -0.17; n = 2884). AEs were increased significantly in the PAMORA group (26 RCTs; RR, 1.10; 95% CI, 1.06-1.15; n = 7715), especially in gastrointestinal disorders, whereas serious AEs were not significant (17 RCTs; RR, 1.04; 95% CI, 0.85-1.28; n = 5890). CONCLUSION:Peripherally acting μ-opioid receptor antagonist has been shown to be effective and durable for patients with OIC and is the only drug with confirmed evidence in meta-analysis. The possibility of publication bias was the limitation of this study.
journal_name
J Gastroenterol Hepatoljournal_title
Journal of gastroenterology and hepatologyauthors
Nishie K,Yamamoto S,Yamaga T,Horigome N,Hanaoka Mdoi
10.1111/jgh.14586subject
Has Abstractpub_date
2019-05-01 00:00:00pages
818-829issue
5eissn
0815-9319issn
1440-1746journal_volume
34pub_type
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journal_title:Journal of gastroenterology and hepatology
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doi:10.1111/j.1440-1746.2005.03243.x
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abstract:AIM:To investigate the morphological changes of intratumoral microvessels after administration of thalidomide in occult hepatic metastases. METHODS:Twenty mice with hepatic metastases created by injection of colon-26 tumor cells into the spleen were enrolled. Ten mice were treated with thalidomide (200 mg/kg) by intra...
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doi:10.1046/j.1440-1746.2001.02558.x
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1046/j.1440-1746.2001.02462.x
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abstract:BACKGROUND:The pathophysiology of constipation is not clearly identified as yet, and the interstital cells of Cajal (ICC), known to generate the slow wave activity and to be involved in intestinal neurotransmission and the enteric nervous system (ENS), are suspected to play an important role. The aims of the present st...
journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1111/j.1440-1746.2005.03809.x
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doi:10.1111/j.1440-1746.2010.06480.x
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pub_type: 杂志文章
doi:10.1111/jgh.14787
更新日期:2019-12-01 00:00:00
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1046/j.1440-1746.2003.02795.x
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1111/jgh.13055
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1046/j.1440-1746.2003.03130.x
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章,meta分析,评审
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1111/jgh.12954
更新日期:2015-09-01 00:00:00
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章,评审
doi:10.1111/j.1440-1746.2003.03158.x
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND AND AIM:Mucosal injury caused by gastroesophageal reflux may result in changes in esophageal mucosal blood flow. Little is known about esophageal mucosal blood flow in patients with gastroesophageal reflux disease (GERD). Here we examined esophageal mucosal blood flow and the effects of treatment in patients...
journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1111/j.1440-1746.2007.05113.x
更新日期:2008-02-01 00:00:00
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1046/j.1440-1746.2000.02193.x
更新日期:2000-05-01 00:00:00
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journal_title:Journal of gastroenterology and hepatology
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章,多中心研究
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
doi:10.1111/jgh.13216
更新日期:2016-04-01 00:00:00
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journal_title:Journal of gastroenterology and hepatology
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1111/j.1440-1746.2012.07122.x
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