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Binding of opioid drugs to intestinal μ-opioid receptors causes the troublesome side effect of constipation. In two identical randomized trials, industry-sponsored researchers have examined the efficacy of naloxegol (Movantik) — a μ-opioid–receptor antagonist currently under FDA review — for treating patients with opioid-induced constipation. The drug does not cross the blood-brain barrier and, thus, does not interfere with opioid analgesia.
A total of 1352 outpatients who were receiving long-term opioid therapy for noncancer pain were enrolled in the two studies; all patients had <3 spontaneous bowel movements weekly plus hard stools, straining, or sensation of incomplete evacuation. Patients received daily placebo or naloxegol (12.5 mg or …