Oral methylnaltrexone does not negatively impact analgesia in patients with opioid-induced constipation and chronic noncancer pain

Journal of Pain Research
Lynn Webster, Robert J Israel

Abstract

An oral formulation of methylnaltrexone has been developed for treating opioid-induced constipation (OIC). This manuscript examines the impact of oral methylnaltrexone, a peripherally acting µ-opioid receptor antagonist, on opioid analgesia. This Phase III, randomized, double-blind, placebo-controlled trial, evaluated changes in pain intensity scores (0= no pain to 10= worst possible pain) and opioid use in adults with chronic noncancer pain. Patients taking ≥50 mg/day oral morphine equivalent dose (MED) for ≥14 days before screening with less than three rescue-free bowel movements/week received oral methylnaltrexone 150 mg/day (n=201), 300 mg/day (n=201), 450 mg/day (n=200), or placebo (n=201) once daily for 4 weeks followed by 8 weeks of oral methylnaltrexone as needed. The primary condition requiring opioid use was back pain (68.2% of 803 patients). Baseline pain intensity scores were similar among treatment groups (mean range, 6.2-6.4) and remained stable throughout the 4-week double-blind (mean range, 6.1-6.5) and 8-week as needed (mean range, 6.3-6.5) periods. Baseline mean MED was comparable between oral methylnaltrexone 150 mg (200.0 mg/day), methylnaltrexone 450 mg (218.0 mg/day), and placebo (209.7 mg/day), but was sl...Continue Reading

Citations

Oct 16, 2018·European Journal of Pain : EJP·Miriam Martínez-NavarroJosep-E Baños
Jul 30, 2020·Regional Anesthesia and Pain Medicine·Eugene R Viscusi, Andrew R Viscusi
May 29, 2020·Alimentary Pharmacology & Therapeutics·Priya VijayvargiyaM Hassan Murad
Jun 24, 2020·Peptides·Richard J Bodnar
Dec 21, 2019·ACS Medicinal Chemistry Letters·Daniel D LongRoss G Vickery

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