Effects of alvimopan: A Synthesis of Findings from 22 Studies

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Original Abstract of the Article

Major Research Findings

Alvimopan has been found to be effective in treating opioid-induced bowel dysfunction (OIBD), specifically opioid-induced constipation (OIC) and postoperative ileus, in numerous studies. 9 , 15 , 18 , 21 , 19 , 22 , 6 , 20 , 16 These studies suggest that alvimopan improves bowel function, resolves bowel obstruction, and contributes to faster recovery, shorter hospital stays, and reduced readmission rates after surgery.

Additionally, alvimopan has shown potential for preventing OIC and postoperative ileus, common side effects of opioids used for pain management after surgery. 1 Alvimopan selectively blocks the effects of opioids in the gut, allowing for pain relief without reducing the analgesic effects of opioids.

Furthermore, studies indicate that alvimopan might accelerate recovery after radical cystectomy, a surgery for bladder cancer. 4 , 9 , 16 These studies suggest that alvimopan may prevent postoperative bowel obstruction, promote bowel movements, and contribute to faster recovery and shorter hospital stays.

Benefits and Risks

Benefit Summary

Alvimopan is an effective medication for treating opioid-induced bowel dysfunction (OIBD), specifically opioid-induced constipation (OIC) and postoperative ileus. Alvimopan improves bowel function, resolves bowel obstruction, and contributes to faster recovery, shorter hospital stays, and reduced readmission rates after surgery. Additionally, alvimopan has shown potential for preventing OIC and postoperative ileus, common side effects of opioids used for pain management after surgery. Furthermore, studies indicate that alvimopan might accelerate recovery after radical cystectomy, a surgery for bladder cancer.

Risk Summary

While alvimopan is generally considered safe, some patients have reported side effects. The most common side effects include abdominal pain, diarrhea, and indigestion. In rare cases, serious side effects such as allergic reactions, low blood pressure, and breathing difficulties have been reported. It is crucial to follow your doctor's instructions when using alvimopan.

Comparison Across Studies

Similarities Across Studies

Numerous studies consistently demonstrate the effectiveness of alvimopan in treating opioid-related side effects, namely OIC and postoperative ileus. These studies also highlight alvimopan's potential to accelerate recovery, shorten hospital stays, and reduce readmission rates after surgery. Collectively, these studies strongly support alvimopan as an effective treatment for OIC and postoperative ileus.

Differences Across Studies

Some studies suggest that the effectiveness of alvimopan may vary depending on the type of surgery and the patient's condition. 12 Furthermore, variations in research findings related to alvimopan's efficacy and safety can be attributed to factors such as study design and patient characteristics.

Consistency and Contradictions in Results

A significant number of studies have consistently shown that alvimopan is an effective treatment for opioid-induced constipation and postoperative ileus. However, some studies indicate that alvimopan's effectiveness may vary depending on the type of surgery and the patient's condition. Additionally, there might be inconsistencies in findings regarding alvimopan's efficacy and safety, likely influenced by factors such as study design and patient characteristics.

Practical Applications and Considerations

Alvimopan is a valuable medication for treating opioid-induced bowel dysfunction (OIBD), specifically opioid-induced constipation (OIC) and postoperative ileus. It is important to note that alvimopan may cause side effects in some individuals. Always follow your doctor's instructions when taking alvimopan. Moreover, it's crucial to understand that alvimopan may not be effective for everyone. Consult with your doctor before using alvimopan.

Current Research Limitations

Research on alvimopan remains limited, particularly regarding long-term effects and safety. Further studies are needed to evaluate the long-term outcomes of alvimopan use and its safety profile. Additionally, it is essential to acknowledge that alvimopan may not be universally effective. It is vital to consult with a doctor before considering alvimopan treatment.

Future Research Directions

Future research should focus on investigating the long-term effects and safety of alvimopan. Further research is required to comprehensively understand the effectiveness of alvimopan in various patient populations and surgical procedures.

Conclusion

Numerous studies have consistently demonstrated the effectiveness of alvimopan in treating opioid-induced bowel dysfunction (OIBD), specifically opioid-induced constipation (OIC) and postoperative ileus. However, it is important to note that alvimopan may cause side effects in some individuals. Always follow your doctor's instructions when taking alvimopan. Moreover, it's crucial to understand that alvimopan may not be effective for everyone. Consult with your doctor before using alvimopan.

Literature analysis of 22 papers
Positive Content
21
Neutral Content
1
Negative Content
0
Article Type
1
3
2
3
21
1.

Strategies to reduce ileus after colorectal surgery: A qualitative umbrella review of the collective evidence.

Author: EmileSameh Hany, HoreshNir, GaroufaliaZoe, GefenRachel, Ray-OfforEmeka, WexnerSteven D

Postoperative ileus

This umbrella review analyzed 26 systematic reviews on interventions to reduce postoperative ileus after colorectal surgery. Early oral feeding, chewing gum, and alvimopan were the most effective strategies. Chewing gum reduced ileus by 45% and shortened time to first flatus and defecation by 11.9 and 17.7 hours, respectively.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

2.

Efficacy of Naldemedine on Intestinal Hypomotility and Adhesions in Rodent Models of Postoperative Ileus.

Author: AzumaYuki, KoikeKatsumi, ChibaHiroki, MitamuraAki, TsujiHiroki, KawasakiSachiko, YokotaTakaaki, KanemasaToshiyuki, MoriokaYasuhide, SuzukiTsutomu, FujitaMasahide

POI treatment

Naldemedine is a peripheral μ-opioid receptor antagonist that is currently being studied as a potential treatment for postoperative ileus (POI). This study found that naldemedine was effective in reducing postoperative intestinal hypomotility and adhesion in rodent models.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

A comparison of naloxegol versus alvimopan at the time of cystectomy and urinary diversion.

Author: FarajKassem S, BunnWeslyn, DurantAdri M, MaulerDavid, ChangYu-Hui H, TysonMark D

Improved perioperative outcomes

This study compares the perioperative outcomes of patients undergoing cystectomy with urinary diversion who receive alvimopan versus naloxegol, two mu-opioid antagonists, to assess their impact on recovery and complications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Efficacy and Safety of Peripherally Acting μ-Opioid Receptor Antagonist (PAMORAs) for the Management of Patients With Opioid-Induced Constipation: A Systematic Review.

Author: RekatsinaMartina, PaladiniAntonella, DrewesAsbjørn M, AyobFarrah, ViswanathOmar, UritsIvan, CorliOscar, PergolizziJoseph, VarrassiGiustino

OIC treatment
Gastrointestinal side effects

Opioid-induced constipation (OIC) is a common side effect of opioid use. Peripherally acting μ-opioid receptor antagonists (PAMORAs) are effective in reducing OIC. Naloxegol and naldemedine are the most effective PAMORAs, with naldemedine leading to more spontaneous bowel movements. While these drugs are generally well-tolerated, common side effects include gastrointestinal issues, nasopharyngitis, and abdominal pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Comparison of treatment to improve gastrointestinal functions after colorectal surgery within enhanced recovery programmes: a systematic review and meta-analysis.

Author: HamelJean F, SabbaghCharles, AlvesArnaud, RegimbeauJean M, VignaudTimothée, VenaraAurélien

Improved GI function recovery
Reduced occurrence of POI

Chewing gum had no significant effect on the occurrence of postoperative ileus, while Alvimopan significantly reduced the occurrence of postoperative ileus in patients undergoing colorectal resection within an enhanced recovery programme (ERP). Randomised controlled trials are needed to confirm these findings.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

A comprehensive SARS-CoV-2 genomic analysis identifies potential targets for drug repurposing.

Author: AnandNithishwer Mouroug, LiyaDevang Haresh, PradhanArpit Kumar, TayalNitish, BansalAbhinav, DonakondaSainitin, JainarayananAshwin Kumar

COVID-19 treatment

This study identified conserved genes in SARS-CoV-2, including NSP10, Nucleoprotein, Plpro, and 3CLpro, which are potential drug targets. Molecular dynamics simulations identified potential drugs for further investigation, including darifenacin, nebivolol, bictegravir, alvimopan, and irbesartan.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

The association of alvimopan treatment with postoperative outcomes after abdominal surgery: A systematic review across different surgical procedures and contexts of perioperative care.

Author: AlhashemiMohsen, HamadRaphael, El-KefraouiCharbel, BlouinMathieu C, Amar-ZifkinAlexandre, LandryTara, LeeLawrence, BaldiniGabriele, FeldmanLiane S, FioreJulio F

Faster GI recovery

Alvimopan is a Food and Drug Administration-approved treatment for accelerating gastrointestinal recovery after abdominal surgery. This study reviews the evidence regarding alvimopan's effects on postoperative outcomes after abdominal surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Efficacy and safety of alvimopan use in benign urinary tract reconstruction.

Author: HensleyPatrick, HigginsMargaret, RasperAlison, ZiadaAli, StrupStephen, ColemanClyde, RufKathryn, GuptaShubham

Faster recovery

This study analyzes the use of alvimopan, a peripheral mu-opioid receptor antagonist, in expediting gastrointestinal recovery after benign abdominal urinary tract reconstruction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Efficacy and Safety of Peripherally Acting Mu-Opioid Receptor Antagonists for the Treatment of Opioid-Induced Constipation: A Bayesian Network Meta-analysis.

Author: OuyangRong, LiZhongzhuan, HuangShijiang, LiuJun, HuangJiean

Effective treatment of OIC

Peripherally acting mu-opioid receptor antagonists (PAMORAs) are effective and safe for the treatment of opioid-induced constipation (OIC). A network meta-analysis of randomized controlled trials found that naldemedine and naloxone were the most effective PAMORAs, showing a better bowel movement response than placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

17.

The contribution of specific enhanced recovery after surgery (ERAS) protocol elements to reduced length of hospital stay after ventral hernia repair.

Author: UelandWalker, Walsh-BlackmoreSeth, NisiewiczMichael, DavenportDaniel L, PlymaleMargaret A, PlymaleMary, RothJohn S

Ventral hernia repair recovery
Prolonged hospitalization

This study evaluated the impact of compliance with individual ventral hernia repair (VHR) enhanced recovery after surgery (ERAS) elements on hospital length of stay (LOS).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Alvimopan is associated with decreased length of stay for both open and laparoscopic segmental colectomy.

Author: HenningRachel E, HuKatherine Y, ReinLisa E, SzaboAniko, PetersonCarrie Y, LudwigKirk A, RidolfiTimothy J

Shorter hospital stay

Alvimopan is a drug that can help patients recover faster after bowel surgery. This study looked at how alvimopan affected length of stay and cost in patients who had open or laparoscopic surgery to remove part of their colon.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

The Impact of Alvimopan on Return of Bowel Function After Major Spine Surgery - A Prospective, Randomized, Double-Blind Study.

Author: DunnLauren K, ThieleRobert H, LinMichelle C, NemergutEdward C, DurieuxMarcel E, TsangSiny, ShaffreyMark E, SmithJustin S, ShaffreyChristopher I, NaikBhiken I

Opioid-induced constipation treatment
Pain management

Pain management following major spine surgery requires high doses of opioids, which are associated with opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

21.

Evaluation of Healthcare Use and Clinical Outcomes of Alvimopan in Patients Undergoing Bowel Resection: A Propensity Score-Matched Analysis.

Author: SteeleScott R, BradyJustin T, CaoZhun, BaumerDorothy L, RobinsonScott B, YangH Keri, DelaneyConor P

Postoperative ileus

Alvimopan was associated with a reduction of 0.62 days in postsurgery length of stay and lower rates of postoperative GI complications, infections, and other in-hospital morbidities in patients undergoing bowel resection surgeries.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

22.

Alvimopan, Regardless of Ileus Risk, Significantly Impacts Ileus, Length of Stay, and Readmission After Intestinal Surgery.

Author: Al-MazrouAhmed M, BaserOnur, KiranRavi P

Improved hospital stay
Reduced ileus

Alvimopan, regardless of ileus risk, improved ileus, hospital stay, and ileus-related readmission after intestinal resection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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