- Methylnaltrexone by subcutaneous injection is significantly more effective than placebo at reducing opioid-induced constipation (OIC) in patients with and without cancer, with no opioid withdrawal symptoms.
- Treatment-related adverse events (AEs) were more common in patients who received methylnaltrexone compared with placebo and most common among those with cancer.
Why this matters
- Methylnaltrexone is effective at reducing OIC without the need to reduce the opioid dose.
- Post-hoc analysis of 2 phase 3, multicenter, double-blind, randomized studies.
- Of 123 patients receiving placebo, 84 had cancer.
- Of 164 patients receiving subcutaneous methylnaltrexone injection, 119 had cancer.
- Funding: Salix Pharmaceuticals.
- More patients treated with methylnaltrexone vs placebo experienced laxation (P<.01 style="list-style-type:circle;">
- Within 4 hours of the first dose:
- Patients with cancer: 55.5% vs 15.5%.
- Patients without cancer: 55.6% vs 12.8%.
- Within 24 hours of the first dose:
- Cancer: 64.7% vs 29.8%.
- Noncancer: 64.4% vs 30.8%.
- Patients with/without cancer were not prespecified populations in the studies.
- Limited generalizability of findings.
Co-authored with Chitra Ravi, MPharm