title: Clinical utility of naloxegol in the treatment of opioid-induced constipation.
abstract: Opioids are a class of medications frequently used for the treatment of acute and chronic pain, exerting their desired effects at central opioid receptors. Agonism at peripherally located opioid receptors, however, leads to opioid-induced constipation (OIC), one of the most frequent and debilitating side effects of prolonged opioid use. Insufficient relief of OIC with lifestyle modification and traditional laxative treatments may lead to decreased compliance with opioid regimens and undertreated pain. Peripherally acting mu-opioid receptor antagonists (PAMORAs) offer the reversal of OIC without loss of central pain relief. Until recently, PAMORAs were restricted to subcutaneous route or to narrow patient populations. Naloxegol is the first orally dosed PAMORA indicated for the treatment of OIC in noncancer patients. Studies have suggested its efficacy in patients failing traditional constipation treatments; however, insufficient evidence exists to establish its role in primary prevention of OIC at this time.
authors.affiliation: Scripps Health and University of California San Diego, Joint Hospice and Palliative Medicine Fellowship, San Diego, CA, USA.
authors.forename: Heather C
authors.initials: HC
authors.lastname: Bruner
authors.affiliation: University of California San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, USA.
authors.forename: Rabia S
authors.initials: RS
authors.lastname: Atayee
authors.affiliation: Department of Medicine, University of California San Diego, Doris A Howell Palliative Care Service, La Jolla, CA, USA.
authors.forename: Kyle P
authors.initials: KP
authors.lastname: Edmonds
authors.affiliation: Department of Medicine, University of California San Diego, Doris A Howell Palliative Care Service, La Jolla, CA, USA.
authors.forename: Gary T
authors.initials: GT
authors.lastname: Buckholz
keywords: OIBD; OIC; bowel care; chronic pain; opioid-induced bowel dysfunction; peripherally-acting mu-opioid antagonist