Bowel function after tapentadol and oxycodone immediate release (IR) treatment in
patients with low back or osteoarthritis pain.
Author(s): Kwong WJ(1), Hammond G, Upmalis D, Okamoto A, Yang M, Kavanagh S.
Affiliation(s): Author information:
(1)QualityMetric Incorporated, Lincoln, RI, USA.
Publication date & source: 2013, Clin J Pain. , 29(8):664-72
OBJECTIVES: Constipation is a common side effect of opioid therapy. Tapentadol
immediate release (IR) was better tolerated than oxycodone IR in 2 clinical
trials involving patients with low back or osteoarthritis pain. The objective of
this study was to examine patient-reported bowel function during those trials.
METHODS: Bowel function was assessed during secondary post hoc analyses using:
the bowel movement questionnaire (BMQ; 10-d trial); the Patient Assessment of
Constipation Symptoms questionnaire (PAC-SYM; 90-day trial); and laxative use
(both trials). Random effects maximum likelihood regressions were run to examine
PAC-SYM data. BMQ data were analyzed using 1-way analyses of variance and a
multinomial logistic regression. Rates of laxative use were compared using χ(2)
statistics.
RESULTS: The 10- and 90-day trials consistently showed that tapentadol IR caused
less impairment of bowel function than oxycodone IR. BMQ data were comparable
between patients receiving tapentadol IR and placebo, and better versus oxycodone
IR including: lower proportion of days where bowel movement was absent (P<0.05);
lower risks of reporting hard stools (P<0.001); and moderate or severe straining
(P<0.001). All PAC-SYM summary scores (abdominal, rectal, stool, overall)
indicated fewer symptoms among patients receiving tapentadol IR versus oxycodone
IR (P<0.001). In both trials, rates of laxative use was lower for tapentadol IR
treatment groups versus oxycodone IR (P<0.001).
DISCUSSION: Patient-reported bowel function associated with tapentadol IR
treatment was similar to that associated with placebo (10-d trial) and
significantly better than that associated with oxycodone IR treatment (10- and
90-d trials).
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