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Related Concept Videos

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Related Experiment Video

Updated: Jan 30, 2026

Movement Retraining using Real-time Feedback of Performance
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The MOVEMENT Trial.

Manne Holm1,2, Per Tornvall3, Loghman Henareh4

  • 11 Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden.

Journal of the American Heart Association
|January 15, 2019
PubMed
Summary

Methylnaltrexone did not improve ticagrelor

Keywords:
ST‐segment–elevation myocardial infarctionangioplasty and stentingantiplatelet therapymyocardial infarctionnarcotic antagonistsopioidpharmacodynamicspharmacokineticspurinergic P2Y receptor antagonists

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Area of Science:

  • Cardiology
  • Pharmacology
  • Gastroenterology

Background:

  • Morphine use in ST-elevation myocardial infarction (STEMI) patients receiving ticagrelor can delay ticagrelor's onset of action due to reduced gastrointestinal motility.
  • Peripheral opioid antagonists may counteract this effect.

Purpose of the Study:

  • To assess if methylnaltrexone improves ticagrelor's pharmacodynamics and pharmacokinetics in STEMI patients concurrently treated with morphine.
  • To evaluate the impact of methylnaltrexone on platelet reactivity and drug concentrations.

Main Methods:

  • The MOVEMENT trial was a multicenter, randomized, controlled study involving 82 STEMI patients on morphine and ticagrelor.
  • Patients received either intravenous methylnaltrexone or placebo before randomization.
  • Platelet reactivity and plasma concentrations of ticagrelor and its metabolite were measured at baseline and 2 hours post-randomization.

Main Results:

  • Methylnaltrexone did not significantly alter high on-treatment platelet reactivity at 2 hours compared to placebo (54% vs. 51%, P=0.84).
  • Plasma concentrations of ticagrelor and its active metabolite showed no significant difference between methylnaltrexone and placebo groups over time.
  • Patient-reported pain levels were also similar between the groups.

Conclusions:

  • Intravenous methylnaltrexone failed to significantly improve ticagrelor's pharmacodynamics or pharmacokinetics in STEMI patients receiving morphine.
  • The study did not support the use of methylnaltrexone to overcome morphine-induced delays in ticagrelor action.