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Opioid-induced constipation: challenges and therapeutic opportunities
1Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic, Rochester, Minnesota 55905, USA. camilleri.michael@mayo.edu
The American Journal of Gastroenterology
|February 24, 2011
Summary
Opiate-induced constipation (OIC) affects 40% of patients on opioid pain relievers. New peripherally acting drugs are being developed to treat OIC and improve pain management.
Area of Science:
- Gastroenterology
- Pharmacology
- Pain Management
Background:
- Increased opioid prescriptions for chronic non-cancer pain over 15 years.
- Opiate-induced constipation (OIC) affects approximately 40% of patients.
- Gastrointestinal symptoms like constipation can limit effective pain relief.
Purpose of the Study:
- To review the pharmacological approaches for preventing and treating OIC.
- To highlight novel drugs and patient response outcomes in OIC management.
Main Methods:
- Review of pharmacological mechanisms of opiates on gastrointestinal function.
- Identification of existing and developing pharmacological treatments for OIC.
- Discussion of novel patient response outcomes for drug development.
Main Results:
- Opiates inhibit colonic transit and secretion, leading to constipation.
- Pharmacological strategies include naloxone formulations and peripherally restricted μ-opiate receptor antagonists.
- New drugs like methylnaltrexone, alvimopan, tapentadol, NKTR-118, and TD-1211 are under development.
Conclusions:
- Effective management of OIC is crucial for successful pain management.
- Development of peripherally acting antagonists offers a promising therapeutic avenue for OIC.
- Novel outcome measures are essential for evaluating new OIC treatments.
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