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Naloxegol for Treatment of Opioid-Induced Constipation in the Pediatric Intensive Care Unit

Ethan L Gillett1,2, Clint A Layes1, Lee Crawley1

  • 1Arkansas Children's Hospital, Little Rock, AR, USA.

Clinical Pediatrics
|December 8, 2022
PubMed

Insights

Naloxegol effectively increased stool frequency in critically ill children with opioid-induced constipation. This treatment did not worsen opioid-withdrawal symptoms, suggesting it is a safe adjunctive therapy.

Area of Science:

  • Pediatric Critical Care Medicine
  • Gastroenterology
  • Pharmacology

Background:

  • Opioid-induced constipation (OIC) is a frequent complication in critically ill children receiving sedation.
  • Naloxegol, an FDA-approved oral peripherally acting mu-opioid receptor antagonist, is used for OIC in adults, but pediatric data are limited.

Purpose of the Study:

  • To evaluate the efficacy and safety of naloxegol for treating OIC in critically ill children.

Main Methods:

  • Retrospective analysis of 45 critically ill children who received naloxegol for OIC.
  • Assessed changes in stool frequency and Withdrawal Assessment Tool 1 (WAT-1) scores before and after naloxegol initiation.

Main Results:

  • Mean stool frequency significantly increased from 0.63 to 1.71 stools/day post-naloxegol (P < .001).
  • No significant difference was observed in WAT-1 scores before and after the first dose (P = .63).

Conclusions:

  • Naloxegol effectively increases stool output in critically ill children with OIC.
  • It appears to be a safe adjunctive therapy, as it does not increase opioid-withdrawal symptoms in this population.

Keywords:
constipationcritically illnaloxegolopioid-antagonistpediatricwithdrawal

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