Investigational opioid antagonists for treating opioid-induced bowel dysfunction
Shilan Mozaffari1,2, Shekoufeh Nikfar2,3, Mohammad Abdollahi4,5
1a Division of Pharmaceutical and Narcotic Affairs, Department of Food and Drug Affairs , Kurdistan University of Medical Science , Sanandaj , Iran.
Expert Opinion on Investigational Drugs
|December 22, 2017
Summary
Novel peripherally acting mu-opioid receptor antagonists (PAMORA) offer a promising approach to manage opioid-induced constipation (OIC) while preserving pain relief. Further research is needed to compare these agents for improved patient quality of life.
Area of Science:
- Pharmacology
- Gastroenterology
- Oncology
Background:
- Opioids are crucial for pain management in cancer and non-cancer patients.
- Opioid-induced constipation (OIC) is a significant adverse effect, often leading to treatment cessation.
- Peripherally acting mu-opioid receptor antagonists (PAMORAs) represent a novel therapeutic strategy to mitigate OIC.
Purpose of the Study:
- To review clinical evidence for investigational PAMORAs.
- To assess the potential of novel agents in reducing OIC without compromising analgesia.
- To highlight the need for agents with specific pharmacokinetic profiles for diverse patient populations.
Main Methods:
- Review of clinical evidence for investigational PAMORAs.
- Inclusion of clinical trials focused on reducing OIC.
- Analysis of agents evaluated in Phase II and Phase III clinical trials.
Main Results:
- TD-1211 is currently in Phase II clinical trials.
- Oxycodone-naltrexone and ADL-5945, previously in Phase III trials, have been discontinued.
- A gap exists in direct comparative studies of available OIC treatment agents.
Conclusions:
- PAMORAs offer a targeted approach to manage OIC.
- There is a need for novel agents with improved selectivity and reduced adverse effects.
- Future research should focus on comparative studies to guide clinical practice and enhance patient quality of life.
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