P0875 - The Role of Peripherally Acting µ-Opioid Receptor Antagonists (PAMORA) in Pediatric Opioid-Induced Bowel Dysfunction

Thu Pham, DO¹, James Noel, MD¹, Robert Noel, MD¹, Lucile McLoughlin, MD¹, Chris Moreau, BSBME², Javier Monagas, MD^1
1Baylor College of Medicine, San Antonio, TX; ²UT Health San Antonio, San Antonio, TX

Introduction: Opioids are well known for the adverse effects involving the gastrointestinal tract which are collectively termed opioid induced bowel dysfunction (OBD). Peripherally acting μ-opioid receptor antagonists (PAMORA) is a recent drug development that have shown to be effective in OBD in adults. However, data on PAMORA use in pediatric population is limited. The purpose of this study is to evaluate the efficacy of PAMORA use in treating pediatric opioid-induced bowel dysfunction.

Methods: This was a retrospective study collected data of patients with opioid induced bowel dysfunction. Patients who received both opioids and methylnaltrexone were randomly matched with control group who received opioids then traditional therapy which included laxative regimen. Control patients were matched based on age, gender, hospital status. The time to first bowel movement was obtained and compared between two groups using Mann-Whitney U test (MWU analysis). The time to achieve goal feed was obtained and compared between 2 groups using MWU analysis. Likert scale data analysis was used to assess potential underlying confounding factors in case group.

Results: 19 cases and 19 controls were included in this study. The mean age was 10.5 years in the case group and 10.6 years in the control group (table 1). 47% of patients requires more than 1 dose of methylnatrexone in order to achieve laxation (table 1). All patients have at least one or more comorbid conditions. The median time to first bowel movement after intervention was 20 hours in case group and 104.7 hours in control group (p=0.002) (table 2). The median time to achieve goal feed was 3 days in case group and 4 days in control group (p=0.928) (table 2). 65% of case patients had low Likert score while 26% of case patients had high Likert score (Figure 1). High Likert-score cases were compared with low Likert-score cases using MWU 2t analysis result in p=0.061

Discussion: The results of this study indicated that PAMORA group takes less time to have spontaneous bowel movement compared to control group. However, there is no significant difference in median time to achieve goal feed, this finding possibly is limited by the number of patients and missing data due to the retrospective nature of this study. All patients in this study have one or more than 1 comorbid conditions. High Likert scores were compared with low Likert scores which revealed that the patients’ comorbid conditions are not likely to interfere with the time to spontaneous bowel movement.




Disclosures:


Thu Pham, DO¹, James Noel, MD¹, Robert Noel, MD¹, Lucile McLoughlin, MD¹, Chris Moreau, BSBME², Javier Monagas, MD¹. P0875 - The Role of Peripherally Acting µ-Opioid Receptor Antagonists (PAMORA) in Pediatric Opioid-Induced Bowel Dysfunction, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.