P2.16-18 Opioid-Induced Constipation in Patients with Cancer Pain in Japan (OIC-J study): A Post-Hoc Analysis of Lung Cancer Patients

Abstract

Opioid-Induced Constipation (OIC) is a common side effect of opioid analgesic therapy. OIC-J study was a multicenter, prospective, observational study of cancer patients who started opioid therapy in Japan (UMIN000025864). The aim of this post-hoc analysis was to clarify the OIC burden focusing on lung cancer patients. This post-hoc analysis was conducted by using a lung cancer patient’s data from OIC-J study. The incidence of OIC was determined by ROME IV diagnostic criteria based on the record of patient diary for 2 weeks, physician’s assessment, spontaneous bowel movement (SBM; <3 SBM/week), Bowel Function Index (BFI; score >28.8) and Patient’s assessment. The change in the Patient Assessment of Constipation-Symptoms (PAC-SYM) score and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) score in 2 weeks after starting opioids were compared between OIC patients and non-OIC patients determined by ROME IV diagnostic criteria. 67 lung cancer patients from 212 in total cancer patients who were registered in OIC-J study were included in this analysis. The incidence of OIC was 48.0% (ROME IV diagnostic criteria), 59.1% (physician’s assessment), 39.1% (SBM) and 53.0% (BFI), respectively. The incidence of OIC by patient’s assessment was 43.5% in 2 weeks after starting opioids (40.3% at a week after staring opioids). The change in PAC-SYM and PAC QOL score in OIC-patients compared to non-OIC patients were 0.399 vs -0.122 (p=0.0031) and 0.214 vs -0.016 (p=0.0540), respectively. The OIC can occur quickly after the initiation of opioid therapy in lung cancer patients and can have an impact on patient’s QOL. These results suggest that an OIC management focusing on a quality and patient’s feeling of bowel movement in early stage in opioid analgesic therapy is important for lung cancer patients.