Alvimopan Decreases Length of Stay, Treatment Costs, in Elective Bowel Resections

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(ChemotherapyAdvisor) – Adding alvimopan, a peripherally acting µ-opioid receptor antagonist, to an established fast-track enhanced recovery protocol significantly decreased length of stay and overall treatment cost in patients undergoing elective bowel resection for cancer, a study concluded during the 66th Annual Society of Surgical Oncology (SSO) Cancer Symposium, held in National Harbor, MD.

Mark J. Ott, MD, of Intermountain Healthcare, Salt Lake City, UT, and colleagues presented results of a subset analysis of a multicenter, double-blind, placebo-controlled trial of 77 patients with a primary diagnosis of small bowel or colonic malignancy from among a population of 246 patients undergoing elective small bowel and colonic resections at eight institutions from 2010 to 2012. The institutions ranged from small community hospitals to a tertiary care center.

“Of the 77 patients, 54 (70%) underwent laparoscopic resections and 23 (30%) underwent open resections and were equally distributed between placebo and alvimopan groups (P=0.5129),” Dr. Ott noted.

The All Patient Diagnosis Related Groups (APDRG) measure of severity of illness was 1 (27 patients, 35%), 2 (44 patients, 57%), 3 (five patients, 6.5%), and 4 (one patient, 1%). Mean/median length of stay for the 42 patients in the placebo arm was 5.9/4.11 days (range, 1.94-30.18 days) compared with 3.9/3.0 days (range, 1.2-13.87 days) for 35 patients in the alvimopan arm (P=0.0149), they reported.

For the patients in the placebo arm, mean/median hospital cost was $16,735/$13,731 compared with $12,965/$11,287 for patients in the alvimopan arm (P=0.0096). In the placebo arm, mean/median pharmacy cost was $1,132/$614 vs $625/$437 for the alvimopan arm (P=0.0369).

No significant differences were observed in re-admission rates (16.7% vs. 11.4%; P=0.75) or return to the operating room (7.1% vs. 2.9%; P=0.62) between the placebo and alvimopan arms.

The abstract (#60) for this presentation is available at the 66th Annual SSO Cancer Symposium's website.

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