A double-blind, randomized, placebo-controlled phase III study of the safety of alvimopan in patients who undergo simple total abdominal hysterectomy.
OBJECTIVE
The purpose of this study was to investigate the safety and efficacy of alvimopan, a novel peripherally acting mu-opioid receptor antagonist, in patients who undergo simple total abdominal hysterectomy.


METHODS
Women (n = 519) were randomized (4:1) to receive alvimopan 12 mg (n = 413) or placebo (n = 106) > or = 2 hours before the operation then twice daily for 7 days (hospital and home). Adverse events were monitored up to 30 days after the last dose of study drug was administered. Efficacy was assessed for 7 postoperative days.


RESULTS
Overall, the most common adverse events were nausea, vomiting, and constipation; < 5% of patients discontinued use because of adverse events. Alvimopan significantly accelerated the time to first bowel movement (hazard ratio, 2.33; P <.001). Average time to first bowel movement was reduced by 22 hours, with more frequent bowel movement and better bowel movement quality found in the treatment cohort.


CONCLUSIONS
Alvimopan has a safety profile that is similar to that of placebo and provides significantly improved lower gastrointestinal recovery in women who undergo simple total abdominal hysterectomy.
Herzog
Thomas J
TJ
Columbia University, New York, NY 10032, USA. th2135@columbia.edu
Coleman
Robert L
RL
Guerrieri
James P
JP
Gabriel
Kathie
K
Du
Wei
W
Techner
Lee
L
Fort
John G
JG
Wallin
Bruce
B
D000328:Adult; D000701:Analgesics, Opioid; D003672:Defecation / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D010147:Pain Measurement; D010880:Piperidines / Q000009:adverse effects / Q000494:pharmacology*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000453:epidemiology; D011184:Postoperative Period; D020127:Recovery of Function; D014594:Uterine Neoplasms / Q000601:surgery
D000701:Analgesics, Opioid; D010880:Piperidines; C419502:alvimopan