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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

843 - Opioid-induced Constipation in Patients with Cancer Pain in Japan: Prospective Observational Study Using Rome IV OIC Diagnostic Criteria (OIC-J Study)

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

End-of-life Care

Tumour Site

Presenters

Hisao Imai

Citation

Annals of Oncology (2018) 29 (suppl_8): viii603-viii640. 10.1093/annonc/mdy300

Authors

H. Imai1, S. Fumita2, T. Harada3, T. Noriyuki4, M. Gamoh5, Y. Akashi6, H. Sato7, Y. Kizawa8, A. Tokoro9

Author affiliations

  • 1 Division Of Respiratory Medicine, Gunma prefectural Cancer Center, 373-8550 - Ota/JP
  • 2 Department Of Medical Oncology, Kindai University Nara hospital, Ikoma/JP
  • 3 Center For Respiratory Diseases, JCHO Hokkaido Hospital, 062-8618 - Sapporo/JP
  • 4 Department Of Surgery, Onomichi General Hospital, Onomichi/JP
  • 5 Department Of Medical Oncology, Osaki Citizen Hospital, 989-6183 - Osaki/JP
  • 6 Department Of Medical Oncology, Kindai University Nara Hospital, Ikoma/JP
  • 7 Medical Affairs, Shionogi & CO., Ltd., 530-0012 - Osaka/JP
  • 8 Department Of Palliative Medicine, Kobe University Graduate School of Medicine, 650-0017 - Kobe/JP
  • 9 Department Of Psychosomatic Internal Medicine And Supportive And Palliative Care Team, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai/JP
More

Resources

Abstract 843

Background

Opioid-Induced Constipation (OIC) is a common side effect of opioid analgesic therapy. However, there were no prospective studies to assess the incidence of OIC of cancer patients. The aim of this study was to evaluate the incidence of OIC from the start of opioid therapy.

Methods

This study was a multicenter, prospective, observational study of cancer patients who started opioid therapy in Japan (UMIN000025864). The incidence of OIC was determined by ROME IV OIC diagnostic criteria based on the record of patient diary for 14 days. The proportion of patients with OIC was calculated for each 1-week period (Week 1 and Week 2) and overall 2-week period. Medication for constipation was allowed during the study period. Patients with <3 bowel movements in the previous week before starting opioid therapy were not allowed to be enrolled. Bowel Function Index (BFI; score >28.8), spontaneous bowel movement (SBM; <3 SBM/week), and physicians’ assessment were also utilized to assess OIC and compare the results.

Results

In total, 212 cancer patients (145 males; mean age 69.1 years)—inpatients and outpatients—with ECOG Performance Status score of 0-2 were included in the study. Mean morphine equivalent dose was 21.9 mg/day. Overall incidence rate of OIC during 2 weeks by weekly diagnosis of Rome IV criteria (total proportion diagnosed as OIC in either Week 1 or Week 2) was 56.1%. The proportion of patients with OIC in Week 1 was 47.6% and in Week 2 was 36.8%. Use of prophylactic laxative reduced the overall incidence rate of OIC from 65.0% to 47.7%. Other diagnostic criteria instead of Rome IV criteria varied the rate; BFI (59.1%), physicians’ assessment (61.4%), SBM frequency (44.8%). When overall 2-week period data were applied to Rome IV OIC criteria, the incidence rate was reduced to 44.2%. Sex and age were not considered as risk factors as opposed to the previous report in some cross-sectional studies. The frequency of SBM/week before starting opioids was identified as the most influencing factor for OIC.

Conclusions

OIC can occur quickly after the initiation of opioid therapy in cancer patients, even if laxatives were utilized prophylactically. The current tools for diagnosing OIC result in varied rates of diagnosis.

Clinical trial identification

UMIN000025864.

Legal entity responsible for the study

Shionogi & Co., Ltd.

Funding

Shionogi & Co., Ltd.

Editorial Acknowledgement

Disclosure

T. Harada: Honoraria: Taiho Pharmaceutical, AstraZeneca K.K., Boehringer Ingelheim, Hisamitsu Pharmaceutical Co, Inc. H. Sato: Employee: Shionogi & Co., Ltd. All other authors have declared no conflicts of interest.

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