PEG vs. sennosides for opioid-induced constipation in cancer care.

Purpose: This randomized double-blind, double-dummy, 2-treatment, 2-period crossover study aimed to compare the efficacy and tolerability of polyethylene glycol (PEG) and sennosides in ambulatory cancer patients with opioid-induced constipation.Methods: Outpatients ≥ 18 years old with cancer, at ris...

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Publicado en:Supportive Care in Cancer Vol. 28; no. 4; pp. 1775 - 1783
Autores principales: Hawley, Philippa, MacKenzie, Hannah, Gobbo, Monica
Formato: research randomized controlled trial Journal Article
Publicado: Springer Nature Apr2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2020
      vid: 28
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00520-019-04944-5
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        atl: PEG vs. sennosides for opioid-induced constipation in cancer care.
      aug:
        au:
          Hawley, Philippa
          MacKenzie, Hannah
          Gobbo, Monica
        affil: Pain and Symptom Management/Palliative Care, British Columbia Cancer, 600 W 10th Ave, V5Z 4E6, Vancouver, BC, Canada
      sug:
        subj:
          Neoplasms Drug Therapy
          Polyethylene Glycols Therapeutic Use
          Patient Satisfaction
          Human
          Male
          Female
          Treatment Outcomes
          Crossover Design
          Double-Blind Studies
          Middle Age
          Aged
          Cathartics Therapeutic Use
          Young Adult
          Defecation Drug Effects
          Aged, 80 and Over
          Analgesics, Opioid Adverse Effects
          Adult
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Randomized Controlled Trials
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: This randomized double-blind, double-dummy, 2-treatment, 2-period crossover study aimed to compare the efficacy and tolerability of polyethylene glycol (PEG) and sennosides in ambulatory cancer patients with opioid-induced constipation.Methods: Outpatients ≥ 18 years old with cancer, at risk of or already experiencing opioid-induced constipation, were randomly assigned to begin a standard bowel protocol of escalating doses of sennosides or PEG, plus a dummy preparation. After 3 weeks, the patients switched to the alternate active product and dummy preparation. Constipation was assessed using the revised Victoria Bowel Performance Scale (rBPS) at the end of each of the 2 consecutive 21-day study periods for the number of days with a satisfactory bowel movement, the time in days to goal rBPS (G), and the treatment preference of each patient.Results: Seventy patients were recruited, with 42 completing their first treatment period and 28 completing both treatment periods. For the typical patient, the expected number of days with a satisfactory bowel movement per days of treatment was found to be 1.21 times higher on PEG than on sennosides in a particular period (95% credible interval 0.96 to 1.55). Patients taking PEG were 1.47 times more likely to reach a rBPS of G before patients taking sennosides in the first period (95% confidence interval 0.74 to 2.94). There was no evidence of a difference in patient preference between laxatives.Conclusion: Our study found weak evidence that PEG is superior to sennosides with respect to overall effectiveness in cancer patients with opioid-induced constipation.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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