Alvimopan for the management of postoperative ileus after bowel resection

Characterization of clinical benefit by pooled responder analysis

Kirk Ludwig, Eugene R. Viscusi, Bruce G. Wolff, Conor P. Delaney, Anthony Senagore, Lee Techner

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: A pooled post hoc responder analysis was performed to assess the clinical benefit of alvimopan, a peripherally acting mu-opioid receptor (PAM-OR) antagonist, for the management of postoperative ileus after bowel resection. Methods: Adult patients who underwent laparotomy for bowel resection scheduled for opioid-based intravenous patient-controlled analgesia received oral alvimopan or placebo preoperatively and twice daily postoperatively until hospital discharge or for 7 postoperative days. The proportion of responders and numbers needed to treat (NNT) were examined on postoperative days (POD) 3-8 for GI-2 recovery (first bowel movement, toleration of solid food) and hospital discharge order (DCO) written. Results: Alvimopan significantly increased the proportion of patients with GI-2 recovery and DCO written by each POD (P <0.001 for all). More patients who received alvimopan achieved GI-2 recovery on or before POD 5 (alvimopan, 80%; placebo, 66%) and DCO written before POD 7 (alvimopan, 87%; placebo, 72%), with corresponding NNTs equal to 7. Conclusions: On each POD analyzed, alvimopan significantly increased the proportion of patients who achieved GI-2 recovery and DCO written versus placebo and was associated with relatively low NNTs. The results of these analyses provide additional characterization and support for the overall clinical benefit of alvimopan in patients undergoing bowel resection.

Original languageEnglish (US)
Pages (from-to)2185-2190
Number of pages6
JournalWorld Journal of Surgery
Volume34
Issue number9
DOIs
StatePublished - 2010
Externally publishedYes

Fingerprint

alvimopan
Ileus
Placebos
Numbers Needed To Treat
Patient-Controlled Analgesia
Narcotic Antagonists
mu Opioid Receptor
Laparotomy
Opioid Analgesics

ASJC Scopus subject areas

  • Surgery

Cite this

Alvimopan for the management of postoperative ileus after bowel resection : Characterization of clinical benefit by pooled responder analysis. / Ludwig, Kirk; Viscusi, Eugene R.; Wolff, Bruce G.; Delaney, Conor P.; Senagore, Anthony; Techner, Lee.

In: World Journal of Surgery, Vol. 34, No. 9, 2010, p. 2185-2190.

Research output: Contribution to journalArticle

Ludwig, Kirk ; Viscusi, Eugene R. ; Wolff, Bruce G. ; Delaney, Conor P. ; Senagore, Anthony ; Techner, Lee. / Alvimopan for the management of postoperative ileus after bowel resection : Characterization of clinical benefit by pooled responder analysis. In: World Journal of Surgery. 2010 ; Vol. 34, No. 9. pp. 2185-2190.
@article{241a48b75da3454b8f8a95bb0df6932d,
title = "Alvimopan for the management of postoperative ileus after bowel resection: Characterization of clinical benefit by pooled responder analysis",
abstract = "Background: A pooled post hoc responder analysis was performed to assess the clinical benefit of alvimopan, a peripherally acting mu-opioid receptor (PAM-OR) antagonist, for the management of postoperative ileus after bowel resection. Methods: Adult patients who underwent laparotomy for bowel resection scheduled for opioid-based intravenous patient-controlled analgesia received oral alvimopan or placebo preoperatively and twice daily postoperatively until hospital discharge or for 7 postoperative days. The proportion of responders and numbers needed to treat (NNT) were examined on postoperative days (POD) 3-8 for GI-2 recovery (first bowel movement, toleration of solid food) and hospital discharge order (DCO) written. Results: Alvimopan significantly increased the proportion of patients with GI-2 recovery and DCO written by each POD (P <0.001 for all). More patients who received alvimopan achieved GI-2 recovery on or before POD 5 (alvimopan, 80{\%}; placebo, 66{\%}) and DCO written before POD 7 (alvimopan, 87{\%}; placebo, 72{\%}), with corresponding NNTs equal to 7. Conclusions: On each POD analyzed, alvimopan significantly increased the proportion of patients who achieved GI-2 recovery and DCO written versus placebo and was associated with relatively low NNTs. The results of these analyses provide additional characterization and support for the overall clinical benefit of alvimopan in patients undergoing bowel resection.",
author = "Kirk Ludwig and Viscusi, {Eugene R.} and Wolff, {Bruce G.} and Delaney, {Conor P.} and Anthony Senagore and Lee Techner",
year = "2010",
doi = "10.1007/s00268-010-0635-9",
language = "English (US)",
volume = "34",
pages = "2185--2190",
journal = "Presentations from the 9th Annual Electric Utilities Environmental Conference",
issn = "0364-2313",
publisher = "Springer New York",
number = "9",

}

TY - JOUR

T1 - Alvimopan for the management of postoperative ileus after bowel resection

T2 - Characterization of clinical benefit by pooled responder analysis

AU - Ludwig, Kirk

AU - Viscusi, Eugene R.

AU - Wolff, Bruce G.

AU - Delaney, Conor P.

AU - Senagore, Anthony

AU - Techner, Lee

PY - 2010

Y1 - 2010

N2 - Background: A pooled post hoc responder analysis was performed to assess the clinical benefit of alvimopan, a peripherally acting mu-opioid receptor (PAM-OR) antagonist, for the management of postoperative ileus after bowel resection. Methods: Adult patients who underwent laparotomy for bowel resection scheduled for opioid-based intravenous patient-controlled analgesia received oral alvimopan or placebo preoperatively and twice daily postoperatively until hospital discharge or for 7 postoperative days. The proportion of responders and numbers needed to treat (NNT) were examined on postoperative days (POD) 3-8 for GI-2 recovery (first bowel movement, toleration of solid food) and hospital discharge order (DCO) written. Results: Alvimopan significantly increased the proportion of patients with GI-2 recovery and DCO written by each POD (P <0.001 for all). More patients who received alvimopan achieved GI-2 recovery on or before POD 5 (alvimopan, 80%; placebo, 66%) and DCO written before POD 7 (alvimopan, 87%; placebo, 72%), with corresponding NNTs equal to 7. Conclusions: On each POD analyzed, alvimopan significantly increased the proportion of patients who achieved GI-2 recovery and DCO written versus placebo and was associated with relatively low NNTs. The results of these analyses provide additional characterization and support for the overall clinical benefit of alvimopan in patients undergoing bowel resection.

AB - Background: A pooled post hoc responder analysis was performed to assess the clinical benefit of alvimopan, a peripherally acting mu-opioid receptor (PAM-OR) antagonist, for the management of postoperative ileus after bowel resection. Methods: Adult patients who underwent laparotomy for bowel resection scheduled for opioid-based intravenous patient-controlled analgesia received oral alvimopan or placebo preoperatively and twice daily postoperatively until hospital discharge or for 7 postoperative days. The proportion of responders and numbers needed to treat (NNT) were examined on postoperative days (POD) 3-8 for GI-2 recovery (first bowel movement, toleration of solid food) and hospital discharge order (DCO) written. Results: Alvimopan significantly increased the proportion of patients with GI-2 recovery and DCO written by each POD (P <0.001 for all). More patients who received alvimopan achieved GI-2 recovery on or before POD 5 (alvimopan, 80%; placebo, 66%) and DCO written before POD 7 (alvimopan, 87%; placebo, 72%), with corresponding NNTs equal to 7. Conclusions: On each POD analyzed, alvimopan significantly increased the proportion of patients who achieved GI-2 recovery and DCO written versus placebo and was associated with relatively low NNTs. The results of these analyses provide additional characterization and support for the overall clinical benefit of alvimopan in patients undergoing bowel resection.

UR - http://www.scopus.com/inward/record.url?scp=79952113772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952113772&partnerID=8YFLogxK

U2 - 10.1007/s00268-010-0635-9

DO - 10.1007/s00268-010-0635-9

M3 - Article

VL - 34

SP - 2185

EP - 2190

JO - Presentations from the 9th Annual Electric Utilities Environmental Conference

JF - Presentations from the 9th Annual Electric Utilities Environmental Conference

SN - 0364-2313

IS - 9

ER -