title: Naloxegol , a new drug for the treatment of opioid-induced constipation.
abstract: BACKGROUND
  With increasing chronic opioid use, opioid-induced constipation (OIC) is becoming a relevant clinical challenge. Presently, only few treatments have been demonstrated to be more effective than placebo in treating OIC but most of them have a restricted clinical application because of side effects. Naloxegol , an orally administered, peripherally acting, μ-opioid receptor antagonist (PAMORA), was developed for the treatment of OIC.
  
  
  METHODS
  This review summarizes published information and presentations at meetings on the effects of naloxegol in OIC. Pharmacodynamic studies have demonstrated that naloxegol inhibits gastrointestinal opioid effects while preserving central analgesic actions. Phase II and Phase III studies in patients with non-cancer OIC have confirmed the efficacy of naloxegol to inhibit OIC, and the most consistent efficacy was seen with the 25 mg dose once daily. Adverse events were mainly gastrointestinal in origin and usually transient and mild. There were no signs of opioid withdrawal in the studies. Safety and tolerability were also shown in a long-term safety study. Regulatory authorities have recently approved the use of naloxegol in OIC.
  
  
  CONCLUSIONS
  Naloxegol is the first approved, orally available PAMORA. The drug has the potential to substantially improve management of OIC patients.
authors.affiliation: Translational Research Center for Gastrointestinal disorders (TARGID), Department of Clinical and Experimental Medicine, University of Leuven , Leuven , Belgium.
authors.forename: Maura
authors.initials: M
authors.lastname: Corsetti
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D000818:Animals; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D003248:Constipation / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D009019:Morphinans / Q000494:pharmacology / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D009019:Morphinans; D011092:Polyethylene Glycols; C000589308:naloxegol
keywords: naloxegol; opioid withdrawal; opioid-induced constipation; randomized controlled clinical trial