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CPT Pharmacometrics Syst Pharmacol ; 5(7): 359-66, 2016 07.
Article in English | MEDLINE | ID: mdl-27435972

ABSTRACT

Naloxegol is a polyethylene glycol derivative of naloxone approved in the US as a once-daily oral treatment for opioid-induced constipation (OIC) in adults with chronic noncancer pain. Population exposure-response models were constructed based on data from two phase III studies comprising 1,331 adults with noncancer pain and OIC. In order to characterize the protocol-defined naloxegol responder rate, the number of daily spontaneous bowel movements (SBMs) was characterized by a longitudinal ordinal nonlinear mixed-effects logistic regression dose-response model, and the incidence of diary entry discontinuation was described by a time-to-event model. The mean number of SBMs per week increased with increasing naloxegol dose. The predicted placebo-adjusted responder rates (90% confidence interval) were 10.4% (4.6-13.4%) and 11.1% (4.8-14.4%) for naloxegol 12.5 and 25 mg/day, respectively. Model-predicted response to naloxegol was influenced by the baseline SBM frequency and characteristics of the opioid treatment.


Subject(s)
Analgesics, Opioid/adverse effects , Chronic Pain/drug therapy , Constipation/chemically induced , Constipation/drug therapy , Models, Statistical , Morphinans/therapeutic use , Narcotic Antagonists/therapeutic use , Polyethylene Glycols/therapeutic use , Adult , Chronic Pain/epidemiology , Clinical Trials, Phase III as Topic/statistics & numerical data , Constipation/epidemiology , Defecation/drug effects , Defecation/physiology , Double-Blind Method , Female , Humans , Male , Medical Records/statistics & numerical data , Middle Aged , Morphinans/pharmacology , Multicenter Studies as Topic/statistics & numerical data , Narcotic Antagonists/pharmacology , Polyethylene Glycols/pharmacology , Randomized Controlled Trials as Topic/statistics & numerical data , Treatment Outcome
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