TY - JOUR
T1 - Alvimopan usage increasing following radical cystectomy
AU - Belle, Joshua D.
AU - Pooli, Aydin
AU - Oleynikov, Dmitry
AU - Deibert, Christopher M.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - 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.
AB - 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.
KW - Alvimopan
KW - Bladder cancer
KW - Cystectomy
KW - Ileus
KW - Vizient
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UR - http://www.scopus.com/inward/citedby.url?scp=85053046946&partnerID=8YFLogxK
U2 - 10.1007/s00345-018-2476-3
DO - 10.1007/s00345-018-2476-3
M3 - Article
C2 - 30196313
AN - SCOPUS:85053046946
SN - 0724-4983
VL - 37
SP - 1151
EP - 1155
JO - World Journal of Urology
JF - World Journal of Urology
IS - 6
ER -