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Alvimopan usage increasing following radical cystectomy

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Abstract

Purpose

Alvimopan (Entereg), a peripherally acting opioid receptor antagonist, is effective in reducing the rate of postoperative ileus and length of hospital stay in patients undergoing colorectal surgery, and is now approved for use after radical cystectomy (RC). Using data from Vizient (formerly University Health System Consortium), we assessed the utilization of alvimopan and its effect on perioperative factors after RC.

Methods

The Vizient database, contributed to by over 200 US academic hospitals, was evaluated from 2014 to 2016. Patients who had undergone radical cystectomy were included. Alvimopan exposure and postoperative outcomes were collected.

Results

7472 patients underwent cystectomy in the 3 years examined, with 3391 (45.4%) patients receiving alvimopan over this time period. The use of alvimopan increased from 35 to 59%. The receipt of alvimopan was associated with a decrease in perioperative morbidity (10.53% vs 19.23%, p = 0.027).

Conclusion

This study, the largest to examine the real-world utilization of alvimopan since FDA approval for RC, shows that alvimopan utilization has increased substantially and is associated with reduced perioperative morbidity in patients undergoing cystectomy.

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Abbreviations

RC:

Radical cystectomy with urinary diversion

ERAS:

Enhanced recovery after surgery

POI:

Postoperative ileus

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Author information

Authors and Affiliations

  1. Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, NE, 68198, USA

    Joshua D. Belle, Aydin Pooli & Christopher M. Deibert

  2. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA

    Dimitry Oleynikov

Authors
  1. Joshua D. Belle
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  2. Aydin Pooli
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  3. Dimitry Oleynikov
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  4. Christopher M. Deibert
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Contributions

JB data analysis, manuscript writing/editing. AP manuscript writing/editing. DO protocol/project development, data collection. CD protocol/project development, data collection and management, manuscript writing/editing

Corresponding author

Correspondence to Joshua D. Belle.

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The authors declare that they have no conflicts of interest.

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For this type of study formal consent is not required.

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Informed consent was obtained from all individual parties included in the study.

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Belle, J.D., Pooli, A., Oleynikov, D. et al. Alvimopan usage increasing following radical cystectomy. World J Urol 37, 1151–1155 (2019). https://doi.org/10.1007/s00345-018-2476-3

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  • DOI: https://doi.org/10.1007/s00345-018-2476-3

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