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Original Research

Development of opioid-induced constipation: post hoc analysis of data from a 12-week prospective, open-label, blinded-endpoint streamlined study in low-back pain patients treated with prolonged-release WHO step III opioids

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Pages 459-475 | Published online: 10 Aug 2015

Figures & data

Figure 1 Patient disposition. Data is presented as n(%) of patients. The arrows indicate insufficient numbers.

Abbreviations: %, percentage of patients; MOR, morphine; n, number of patients; OXN, oxycodone/naloxone; OXY, oxycodone; TEAE, treatment emergent adverse event.
Figure 1 Patient disposition. Data is presented as n(%) of patients. The arrows indicate insufficient numbers.

Table 1 Patient demographics and baseline characteristics

Figure 2 Change in mean BFI score during the course of the 12-week study.

Notes: BFI changed significantly for all three treatment groups vs baseline but significantly less for oxycodone/naloxone vs oxycodone vs morphine. The horizontal line marked with “28.8” indicates the upper normal reference range of the BFI; the horizontal bars indicate significance level with respect to treatment comparisons between oxycodone/naloxone vs oxycodone and morphine. The VAS100 was scored as 0= no bowel dysfunction and 100= worst bowel dysfunction conceivable.
Abbreviations: BFI, Bowel Function Index; BL, baseline; VAS100, 100 mm horizontal visual analog scale; W, treatment week.
Figure 2 Change in mean BFI score during the course of the 12-week study.

Table 2 Primary endpoint analysis

Figure 3 Proportion of patients who recorded a Bowel Function Index score above the normal range (≥28.8) (left), a significant worsening vs baseline (≥12 mm) (middle), and a CSBM ≥1 decrease vs baseline (right) at the end of a 12-week treatment with morphine (light grey), oxycodone (grey), and oxycodone/naloxone (dark grey).

Note: *Significant difference (P<0.001) for oxycodone/naloxone vs morphine and vs oxycodone.
Abbreviations: BFI, Bowel Function Index; CSBM, complete spontaneous bowel movement; VAS100, 100 mm horizontal visual analog scale.
Figure 3 Proportion of patients who recorded a Bowel Function Index score above the normal range (≥28.8) (left), a significant worsening vs baseline (≥12 mm) (middle), and a CSBM ≥1 decrease vs baseline (right) at the end of a 12-week treatment with morphine (light grey), oxycodone (grey), and oxycodone/naloxone (dark grey).

Table 3 Secondary tolerability analysis

Figure 4 Proportion of patients who recorded a ≥50% improvement (vs baseline) with respect to pain intensity (left), pain-related disabilities in daily life (middle), and quality of life (right) at the end of a 12-week treatment with morphine (light grey), oxycodone (grey), and oxycodone/naloxone (dark grey).

Note: *Significant difference (P<0.001) for oxycodone/naloxone vs morphine and vs oxycodone.
Abbreviation: QoL, quality of life.
Figure 4 Proportion of patients who recorded a ≥50% improvement (vs baseline) with respect to pain intensity (left), pain-related disabilities in daily life (middle), and quality of life (right) at the end of a 12-week treatment with morphine (light grey), oxycodone (grey), and oxycodone/naloxone (dark grey).

Figure 5 Distribution of time to onset of TEAEs reported for morphine (dashed line), oxycodone (dotted line), and oxycodone/naloxone (solid line) during a 12-week treatment period.

Abbreviation: TEAE, treatment-emergent adverse event.
Figure 5 Distribution of time to onset of TEAEs reported for morphine (dashed line), oxycodone (dotted line), and oxycodone/naloxone (solid line) during a 12-week treatment period.

Figure 6 Number of TEAEs (left), patients affected by TEAEs (middle), and patients forced to discontinue treatment due to a TEAE (right), recorded during a 12-week treatment with morphine (light grey), oxycodone (grey), and oxycodone/naloxone (dark grey).

Note: *Significant difference (P<0.001) for oxycodone/naloxone vs morphine and vs oxycodone.
Abbreviation: TEAEs, treatment-emergent adverse events.
Figure 6 Number of TEAEs (left), patients affected by TEAEs (middle), and patients forced to discontinue treatment due to a TEAE (right), recorded during a 12-week treatment with morphine (light grey), oxycodone (grey), and oxycodone/naloxone (dark grey).

Table 4 Overall TEAE experience