Journal of palliative medicine · 2026
Can Naldemedine Allow Higher Oxycodone Dosing in Patients with Cancer? A Single-Center Retrospective Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Kajiura Shinya, Chikaoka Shingo, Yagi Yuta, Ryu Nobukazu, Matsushita Takako, Kurokawa Mami, Yoshida Akihiro, Kanai Nahoko, Mizuno Yoko, Yuki Ryutatsu, Nagata Kohei, Motoo Iori, Ando Takayuki, Yasuda Ichiro, Hayashi Ryuji
Аннотация
BACKGROUND: Opioid-induced constipation (OIC) limits opioid titration in cancer care. Before the use of peripherally acting μ-opioid receptor antagonists (PAMORAs), OIC often required switching from oxycodone to lower-risk opioids, such as transdermal fentanyl. Whether naldemedine allows oxycodone escalation without switching remains unclear. We evaluated the maximum scheduled daily oxycodone dose as a surrogate for maintaining therapy without constipation-driven switching.
METHODS: We retrospectively reviewed adults with cancer pain who initiated oral oxycodone at Toyama University Hospital between June 2017 and December 2018. Patients receiving naldemedine were classified as Group A; others as Group B. The primary endpoint was the maximum scheduled controlled-release oxycodone dose during follow-up; rescue doses were excluded.
RESULTS: Among 217 patients, the median maximum dose was higher with naldemedine (40 mg/day [range 10-480] versus 20 mg/day [10-320]; p < 0.0001).
CONCLUSIONS: Naldemedine enabled higher oxycodone dosing, suggesting OIC management reduces opioid switching.
METHODS: We retrospectively reviewed adults with cancer pain who initiated oral oxycodone at Toyama University Hospital between June 2017 and December 2018. Patients receiving naldemedine were classified as Group A; others as Group B. The primary endpoint was the maximum scheduled controlled-release oxycodone dose during follow-up; rescue doses were excluded.
RESULTS: Among 217 patients, the median maximum dose was higher with naldemedine (40 mg/day [range 10-480] versus 20 mg/day [10-320]; p < 0.0001).
CONCLUSIONS: Naldemedine enabled higher oxycodone dosing, suggesting OIC management reduces opioid switching.