Open AccessSubcutaneous methylnaltrexone for opioid-induced constipation in advanced-illness patients with or without active cancer
Author(s) -
Bruce Chamberlain,
Michelle Rhiner,
Neal E. Slatkin,
Nancy Stambler,
Robert Israel
Publication year - 2020
Publication title -
pain management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.402
H-Index - 21
eISSN - 1758-1877
pISSN - 1758-1869
DOI - 10.2217/pmt-2019-0045
Subject(s) - medicine , placebo , constipation , opioid , anesthesia , post hoc analysis , cancer , clinical trial , receptor , alternative medicine , pathology
Aim: To evaluate methylnaltrexone for opioid-induced constipation in patients with and without cancer. Methods: This post hoc analysis comprises two Phase III, multicenter, double-blind, randomized studies of advanced-illness patients who received methylnaltrexone subcutaneous injection or placebo. Results: Significantly more patients treated with methylnaltrexone than placebo experienced laxation within 4 (cancer = 55.5 vs 15.5%; noncancer = 55.6 vs 12.8%) and 24 (cancer = 64.7 vs 29.8%; noncancer = 64.4 vs 30.8%) h after the first dose (p < 0.01 vs placebo). Regardless of cancer status, methylnaltrexone reduced median time to laxation and improved constipation relief without impacting opioid analgesia or withdrawal symptoms. Conclusion: Methylnaltrexone provided significant improvements in opioid-induced constipation over placebo in advanced-illness patients with and without cancer. Clinical trial registration numbers: study 301: NCT00401362; study 302: NCT00402038.