2021
DOI: 10.2147/jpr.s312731
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Subcutaneous Methylnaltrexone for Treatment of Opioid-Induced Constipation in Cancer versus Noncancer Patients: An Analysis of Efficacy and Safety Variables from Two Studies

Abstract: Purpose: Methylnaltrexone inhibits opioid-induced constipation (OIC) by binding to peripheral µ-opioid receptors without impacting central opioid receptor mediated analgesia. This analysis compared methylnaltrexone efficacy and safety among advanced illness patients with and without active cancer and OIC. Patients and Methods: This post hoc analysis included two multicenter, randomized, doubleblind, placebo-controlled studies in adults with advanced illness and OIC who received subcutaneous methylnaltrexone. E… Show more

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Cited by 6 publications
(5 citation statements)
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“…Until recently, there were no studies comparing SC methylnaltrexone use among patients with and without cancer; this pooled analysis of studies 302 and 4000 by Chamberlain et al is the first study to make this comparison. The results of the individual studies in this post hoc analysis support and are consistent with those of the pooled analysis, 18 providing further evidence that methylnaltrexone effectively treats OIC in patients with advanced illnesses, including patients with cancer. Furthermore, in a 2019 prospective observational study, efficacy of SC methylnaltrexone was evaluated in 23 patients with cancer and OIC per opioid subtype (oxycodone, fentanyl).…”
supporting
confidence: 79%
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“…Until recently, there were no studies comparing SC methylnaltrexone use among patients with and without cancer; this pooled analysis of studies 302 and 4000 by Chamberlain et al is the first study to make this comparison. The results of the individual studies in this post hoc analysis support and are consistent with those of the pooled analysis, 18 providing further evidence that methylnaltrexone effectively treats OIC in patients with advanced illnesses, including patients with cancer. Furthermore, in a 2019 prospective observational study, efficacy of SC methylnaltrexone was evaluated in 23 patients with cancer and OIC per opioid subtype (oxycodone, fentanyl).…”
supporting
confidence: 79%
“…Among patients with comparable methylnaltrexone dosing regimens, time to first rescue-free laxation was shorter for those with cancer than for those without cancer. 18 …”
Section: Discussionmentioning
confidence: 99%
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“…As has been described previously, rates of rescue-free laxation were similar in patients with and without cancer who were receiving methylnaltrexone. 22 This analysis also showed that rates of rescue-free laxation with methylnaltrexone were similar between patients with lower (better) and higher (worse) ECOG performance status scores, although there was a slight numerical trend toward higher response rates in patients with lower scores. Overall, rates of TEAEs and rates of gastrointestinal TEAEs were somewhat higher in patients with cancer than those without but similar between patients treated with methylnaltrexone and placebo.…”
Section: Discussionmentioning
confidence: 67%
“…[15][16][17][18] MNTX tablets and subcutaneous (SC) injections are approved for the treatment of OIC in adults with chronic noncancer pain, including patients with chronic pain related to prior cancer or its treatment who do not require frequent (eg, weekly) opioid dosage escalation. 15 In addition, MNTX injection is the only PAMORA 19 indicated for the treatment of OIC in adults with advanced illness or pain caused by active cancer who require opioid dosage escalation for palliative care. 15 We present a post hoc analysis of pooled results from 3 randomized, placebo-controlled trials of MNTX treatment for patients with advanced illness and OIC.…”
Section: Introductionmentioning
confidence: 99%