PMID- 19278178
OWN - NLM
STAT- MEDLINE
DCOM- 20090421
LR  - 20220330
IS  - 1544-6794 (Print)
IS  - 1544-6794 (Linking)
VI  - 7
IP  - 1
DP  - 2009 Jan-Feb
TI  - Methylnaltrexone for treatment of opioid-induced constipation in advanced illness 
      patients.
PG  - 39-46
AB  - Methylnaltrexone, a peripheral mu-opioid receptor antagonist with restricted 
      ability to cross the blood-brain barrier, may relieve opioid-induced constipation 
      (OIC) without reversing analgesia. A total of 154 patients with advanced illness 
      and OIC enrolled in a double-blind, randomized, placebo-controlled trial, with 
      optional open-label phases (up to 4 months) in hospice and palliative care 
      centers during 2003-2005. They received a single subcutaneous injection of 
      methylnaltrexone (0.15 mg/kg or 0.3 mg/kg) or placebo. Laxation response within 4 
      hours was 62% and 58% for methylnaltrexone 0.15 mg/kg and 0.3 mg/kg, 
      respectively, compared with 14% for placebo (P < 0.0001; each dose vs placebo). 
      Approximately half of the methylnaltrexone responders defecated within 30 minutes 
      of dosing. Open-label phase response rates mirrored those for methylnaltrexone 
      during the double-blind phase.There was no change in pain scores or evidence of 
      central opioid withdrawal.The most common adverse events (AEs) were abdominal 
      pain and flatulence.Three patients had serious AEs attributed to 
      methylnaltrexone. Subcutaneous methylnaltrexone was efficacious in rapidly 
      inducing laxation and was generally well tolerated in patients with advanced 
      illness and OIC.
FAU - Slatkin, Neal
AU  - Slatkin N
AD  - Department of Supportive Care, Pain and Palliative Medicine, City of Hope Medical 
      Center, 1500 East Duarte Road, Duarte, CA 91010, USA. pallcaredr@yahoo.com
FAU - Thomas, Jay
AU  - Thomas J
FAU - Lipman, Arthur G
AU  - Lipman AG
FAU - Wilson, George
AU  - Wilson G
FAU - Boatwright, Michelle L
AU  - Boatwright ML
FAU - Wellman, Charles
AU  - Wellman C
FAU - Zhukovsky, Donna S
AU  - Zhukovsky DS
FAU - Stephenson, Richard
AU  - Stephenson R
FAU - Portenoy, Russell
AU  - Portenoy R
FAU - Stambler, Nancy
AU  - Stambler N
FAU - Israel, Robert
AU  - Israel R
LA  - eng
SI  - ClinicalTrials.gov/NCT00401362
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Support Oncol
JT  - The journal of supportive oncology
JID - 101181305
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Narcotic Antagonists)
RN  - 0 (Quaternary Ammonium Compounds)
RN  - 0 (Receptors, Opioid, mu)
RN  - 0RK7M7IABE (methylnaltrexone)
RN  - 5S6W795CQM (Naltrexone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analgesia/methods
MH  - Analgesics, Opioid/*adverse effects
MH  - Constipation/chemically induced/*drug therapy
MH  - Critical Illness
MH  - Defecation/*drug effects
MH  - Dose-Response Relationship, Drug
MH  - Double-Blind Method
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Naltrexone/*analogs & derivatives/therapeutic use
MH  - Narcotic Antagonists/*therapeutic use
MH  - Pain Measurement
MH  - Quaternary Ammonium Compounds/therapeutic use
MH  - Receptors, Opioid, mu/drug effects
MH  - Treatment Outcome
EDAT- 2009/03/13 09:00
MHDA- 2009/04/22 09:00
CRDT- 2009/03/13 09:00
PHST- 2009/03/13 09:00 [entrez]
PHST- 2009/03/13 09:00 [pubmed]
PHST- 2009/04/22 09:00 [medline]
PST - ppublish
SO  - J Support Oncol. 2009 Jan-Feb;7(1):39-46.