Alvimopan accelerates gastrointestinal recovery after bowel resection regardless of age, gender, race, or concomitant medication use

Anthony J. Senagore, Joel J. Bauer, Wei Du, Lee Techner

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Postoperative ileus is a transient cessation of bowel motility that occurs after bowel resection (BR). Alvimopan, a peripherally acting μ-opioid receptor antagonist accelerated gastrointestinal (GI) recovery in 5 randomized, double-blind, phase III postoperative ileus trials. Methods: Individual covariates (age, gender, race) were assessed separately using Cox proportional hazards models that included the main effects of treatment and covariate factor. Time-to-GI recovery (GI-3 [first toleration of solid food and first bowel movement or flatus]; GI-2 [first toleration of solid food and first bowel movement]) for patients who underwent open laparotomy for BR in the absence of epidural anesthesia and received alvimopan (12 mg) or placebo was analyzed within subgroups (age, gender, race, concomitant medication use) using Cox proportional hazards models to generate hazard ratios (HRs). P values were calculated with the Wald χ 2 test. Results: Elderly (≥65 years), male, and nonwhite patients achieved GI-3 recovery later than younger ( 1 and P <.05 for all). Overall, alvimopan (12 mg) accelerated GI-3 recovery by 12 hours and GI-2 recovery by 17 hours compared with placebo. Within subgroups, regardless of covariate effect, patients who received alvimopan (12 mg) achieved GI-2 and GI-3 recovery sooner than patients who received placebo (HR > 1 and P <.05 for all). Conclusions: These post hoc analyses support that alvimopan (12 mg) accelerates GI recovery across various patient populations.

Original languageEnglish (US)
Pages (from-to)478-486
Number of pages9
JournalSurgery
Volume142
Issue number4
DOIs
StatePublished - Oct 2007
Externally publishedYes

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alvimopan
Ileus
Proportional Hazards Models
Flatulence
Food
Narcotic Antagonists
Epidural Anesthesia
Laparotomy
Placebos
Population

ASJC Scopus subject areas

  • Surgery

Cite this

Alvimopan accelerates gastrointestinal recovery after bowel resection regardless of age, gender, race, or concomitant medication use. / Senagore, Anthony J.; Bauer, Joel J.; Du, Wei; Techner, Lee.

In: Surgery, Vol. 142, No. 4, 10.2007, p. 478-486.

Research output: Contribution to journalArticle

Senagore, Anthony J. ; Bauer, Joel J. ; Du, Wei ; Techner, Lee. / Alvimopan accelerates gastrointestinal recovery after bowel resection regardless of age, gender, race, or concomitant medication use. In: Surgery. 2007 ; Vol. 142, No. 4. pp. 478-486.
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abstract = "Background: Postoperative ileus is a transient cessation of bowel motility that occurs after bowel resection (BR). Alvimopan, a peripherally acting μ-opioid receptor antagonist accelerated gastrointestinal (GI) recovery in 5 randomized, double-blind, phase III postoperative ileus trials. Methods: Individual covariates (age, gender, race) were assessed separately using Cox proportional hazards models that included the main effects of treatment and covariate factor. Time-to-GI recovery (GI-3 [first toleration of solid food and first bowel movement or flatus]; GI-2 [first toleration of solid food and first bowel movement]) for patients who underwent open laparotomy for BR in the absence of epidural anesthesia and received alvimopan (12 mg) or placebo was analyzed within subgroups (age, gender, race, concomitant medication use) using Cox proportional hazards models to generate hazard ratios (HRs). P values were calculated with the Wald χ 2 test. Results: Elderly (≥65 years), male, and nonwhite patients achieved GI-3 recovery later than younger ( 1 and P <.05 for all). Overall, alvimopan (12 mg) accelerated GI-3 recovery by 12 hours and GI-2 recovery by 17 hours compared with placebo. Within subgroups, regardless of covariate effect, patients who received alvimopan (12 mg) achieved GI-2 and GI-3 recovery sooner than patients who received placebo (HR > 1 and P <.05 for all). Conclusions: These post hoc analyses support that alvimopan (12 mg) accelerates GI recovery across various patient populations.",
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