{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T21:29:02Z","timestamp":1763069342829,"version":"build-2065373602"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Medical benefits of peripherally acting mu\u2010opioid receptor antagonists other than improving opioid\u2010induced constipation remain unclear. Our aim was to evaluate the association between the use of naldemedine and incidence of hyperactive delirium in cancer patients receiving chemotherapy and opioid therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a propensity score\u2010matched analysis using a nationwide inpatient database in Japan. Cancer patients receiving both inpatient chemotherapy and opioid therapy from June 1, 2017, to March 31, 2018, were included. Patients receiving naldemedine were matched to control patients by propensity score. Our primary outcome was the incidence of hyperactive delirium during hospitalization, and secondary outcomes were the length of hospital stay, hospital costs, in\u2010hospital mortality, and incidence of ileus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 34,031 patients receiving inpatient chemotherapy and opioid therapy, 1905 (5.6%) were included in the naldemedine group. After one\u2010to\u2010four propensity score matching, 1904 patients were included in the naldemedine group and 7616 in the control group. Naldemedine users had significantly reduced incidence of hyperactive delirium compared with the control patients (19.4% vs 23.3%; risk difference, \u22123.9 [95% confidence interval, \u22125.9 to \u22121.9]; risk ratio, 0.83 [0.75\u20130.92]; <jats:italic>p<\/jats:italic>&lt;0.001; subdistribution hazard ratio, 0.85 [0.75\u20130.97]; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015). The median length of hospital stay was significantly shorter in the naldemedine group compared with the control group (12\u00a0days [interquartile range, 6\u201323] vs 14\u00a0days [6\u201326]; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001). The median hospital costs were also significantly lower in the naldemedine group compared with the control group (US $6179 [3351\u201310,026] vs US $6576 [3436\u201311,107]; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). No significant differences were found for in\u2010hospital mortality or incidence of ileus between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings suggest that the use of naldemedine may have benefits in preventing hyperactive delirium, shortening hospital stay, and decreasing hospital costs in cancer patients receiving chemotherapy and opioid therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2658","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T07:13:31Z","timestamp":1640848411000},"page":"241-249","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Use of naldemedine is associated with reduced incidence of hyperactive delirium in cancer patients with opioid\u2010induced constipation: A nationwide retrospective cohort study in Japan"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2493-302X","authenticated-orcid":false,"given":"Hiroaki","family":"Abe","sequence":"first","affiliation":[{"name":"Department of Pain and Palliative Medicine The University of Tokyo Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Sumitani","sequence":"additional","affiliation":[{"name":"Department of Pain and Palliative Medicine The University of Tokyo Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reo","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Relief Center The University of Tokyo Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics Tokyo Medical and Dental University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanji","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Relief Center The University of Tokyo Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1191\/0269216304pm879oa"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60688-1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy147"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1860"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7491"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1859"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.73.0853"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000852"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2013.851082"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14033"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049909115624703"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12724"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640615604543"},{"key":"e_1_2_8_15_1","first-page":"25","article-title":"Development and use of the Japanese case\u2010mix system","volume":"14","author":"Matsuda S","year":"2008","journal-title":"Eurohealth"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-0889-x"},{"key":"e_1_2_8_17_1","unstructured":"Ministry of Health Labour and Welfare of Japan.Expected volume of participating hospitals and preparatory hospitals in the Diagnosis Procedure Combination database in 2017. 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