Over the years opioid receptor antagonists like methylnaltrexone, naloxegol and naloxone are increasingly being used for the pathophysiological treatment of opioid induced constipation (OIC). The efficacy of laxative treatment and pathophysiological treatment with a prolonged release combination of oxycodone/naloxone (PR OXN) in daily practice is not clear. With this thesis we aimed to gain insights in the efficacy PR OXN treatment for OIC, with a focus on patients with laxative refractory OIC. Moreover, since data are lacking on the efficacy of the current Dutch laxative regime a pilot study was performed aiming to obtain insights in the efficacy of the current Dutch laxative regime in daily practice. Also, a systematic review was performed to gain insights on the current clinical and observational study evidence of the efficacy of peripherally acting mu-opioid receptor antagonists (PAMORAs) and PR OXN. Finally, a cost-utility analysis was performed for PR OXN use in patients with non-malignant moderate-to-severe pain, who are eligible for opioid treatment to obtain adequate analgesia and are experiencing laxative-refractory OIC.

Additional Metadata
Keywords Opioid induced constipation, oxycodone, naloxone, opioid antagonists, PAMORA, oxycodone/naloxone combinations, efficacy, RCT, real-world evidence
Promotor F.J.P.M. Huygen (Frank) , M. Dirckx (Maaike)
Publisher Erasmus University Rotterdam
ISBN 978-94-6361-243-2
Persistent URL hdl.handle.net/1765/116451
Koopmans-Klein, G. (2019, July 3). The efficacy of prolonged release oxycodone/naloxone for the treatment of Opioid Induced Constipation; from clinical trial to daily practice. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/116451