Effects of methylnaltrexone: A Synthesis of Findings from 11 Studies

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Original Abstract of the Article

Major Research Findings

Methylnaltrexone, a peripherally acting mu-opioid receptor antagonist, has been studied extensively for its potential to alleviate opioid-induced constipation without affecting pain relief. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 Research has shown that methylnaltrexone can effectively reduce constipation, improve gastrointestinal transit time, and potentially alleviate other opioid-related side effects. 3 , 5 , 1 However, a common adverse event associated with methylnaltrexone is abdominal pain. 8 There's also a potential for methylnaltrexone to worsen gastrointestinal pain. 10 These findings underscore the importance of considering both the benefits and risks of methylnaltrexone treatment.

Benefits and Risks

Benefit Summary

Methylnaltrexone offers a potential solution for managing opioid-induced constipation. It effectively alleviates constipation while maintaining the pain-relieving effects of opioids. 8 , 3 , 5 , 1 It also shows promise in improving gastrointestinal transit time and reducing discomfort associated with opioid use. 3 , 5 , 1 For patients receiving palliative care, methylnaltrexone could potentially improve their quality of life by alleviating the debilitating effects of opioid-induced constipation.

Risk Summary

Methylnaltrexone can cause side effects such as abdominal pain. 8 Additionally, studies suggest that methylnaltrexone might exacerbate existing gastrointestinal pain. 10 It's essential to understand these risks and to discuss them with your doctor before considering methylnaltrexone treatment.

Comparison Between Studies

Commonalities Between Studies

Across various studies, methylnaltrexone has consistently demonstrated effectiveness in treating opioid-induced constipation. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 It effectively alleviates constipation without diminishing pain relief provided by opioids, and also improves gastrointestinal transit time. 3 , 5 , 1 These consistent findings strongly suggest that methylnaltrexone is a valuable treatment option for opioid-induced constipation.

Differences Between Studies

Some variations exist between studies, such as the administration route of methylnaltrexone, the study population, and study design. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 For instance, certain studies reported abdominal pain as a potential side effect of methylnaltrexone. 8 Conversely, other studies indicated that methylnaltrexone could exacerbate pre-existing gastrointestinal pain. 10 These discrepancies might be attributable to differences in study design, participant characteristics, or other factors. Conducting further research is crucial to gain a deeper understanding of the safety and efficacy of methylnaltrexone.

Consistency and Contradictions in Findings

A significant body of research consistently supports the effectiveness of methylnaltrexone in managing opioid-induced constipation. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 It effectively alleviates constipation without diminishing the pain-relieving effects of opioids. 3 , 5 , 1 However, a potential for abdominal pain as a side effect has been observed. 8 Some research suggests that methylnaltrexone might worsen existing gastrointestinal pain. 10 These conflicting findings highlight the need for continued research to better understand the nuances of methylnaltrexone's effects and to identify potential mitigating factors.

Considerations for Real-World Application

While methylnaltrexone shows promise as a treatment for opioid-induced constipation, it's essential to approach its use with a balanced perspective. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 It's crucial to discuss the potential benefits and risks of methylnaltrexone with your healthcare provider. Consider your individual medical history, current medications, and potential for gastrointestinal pain when making treatment decisions.

Limitations of Current Research

The research on methylnaltrexone is ongoing, and there is a need for more comprehensive studies. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 Specifically, long-term safety and efficacy data remain limited. More research is needed to assess the potential long-term consequences of methylnaltrexone use.

Future Research Directions

Future research should focus on addressing the limitations of current studies. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 Long-term safety and efficacy studies are crucial, along with investigations into potential variations in response based on age, gender, and underlying medical conditions. Additionally, research should explore interactions between methylnaltrexone and other medications.

Conclusion

Methylnaltrexone appears promising as a treatment for opioid-induced constipation, with numerous studies demonstrating its effectiveness. 8 , 10 , 9 , 6 , 3 , 5 , 1 , 4 , 2 , 11 , 7 However, potential side effects, including abdominal pain, need careful consideration. Before using methylnaltrexone, it's vital to discuss its risks and benefits with your healthcare provider and weigh them against your individual medical history and circumstances.

Literature analysis of 11 papers
Positive Content
11
Neutral Content
0
Negative Content
0
Article Type
11
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0
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11
1.

Methylnaltrexone prevents morphine-induced delay in oral-cecal transit time without affecting analgesia: a double-blind randomized placebo-controlled trial.

Author: YuanC S, FossJ F, O'ConnorM, ToledanoA, RoizenM F, MossJ

Opioid-induced constipation relief

Methylnaltrexone, a quaternary opioid antagonist, effectively prevented morphine-induced changes in gastrointestinal motility and transit without affecting analgesia in humans. This suggests potential for methylnaltrexone as an adjunct to opioids for managing opioid-induced constipation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

2.

Safety and tolerance of methylnaltrexone in healthy humans: a randomized, placebo-controlled, intravenous, ascending-dose, pharmacokinetic study.

Author: FossJ F, O'ConnorM F, YuanC S, MurphyM, MossJ, RoizenM F

Opioid side effects treatment
Orthostatic hypotension

This study found that methylnaltrexone, a quaternary opioid antagonist, was well tolerated at doses of 0.32 mg/kg in healthy humans, with the dose-limiting adverse effect being orthostatic hypotension.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

3.

The safety and efficacy of oral methylnaltrexone in preventing morphine-induced delay in oral-cecal transit time.

Author: YuanC S, FossJ F, OsinskiJ, ToledanoA, RoizenM F, MossJ

Oral methylnaltrexone
Prevents constipation

Oral methylnaltrexone, a quaternary opioid antagonist, effectively prevented morphine-induced delay in gastrointestinal transit in healthy volunteers. This suggests its potential use in managing opioid-induced constipation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

4.

Efficacy of orally administered methylnaltrexone in decreasing subjective effects after intravenous morphine.

Author: YuanC S, FossJ F, O'ConnorM, OsinskiJ, RoizenM F, MossJ

Reduce opioid side effects

Oral methylnaltrexone, a selective peripheral opioid receptor antagonist, significantly decreased subjective ratings of nausea, skin itch, stimulated, and flushing after intravenous morphine injection.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

5.

Effects of enteric-coated methylnaltrexone in preventing opioid-induced delay in oral-cecal transit time.

Author: YuanC S, FossJ F, O'ConnorM, KarrisonT, OsinskiJ, RoizenM F, MossJ

Gastrointestinal effects prevention

Methylnaltrexone, the first peripheral opioid receptor antagonist, has the potential to prevent or reverse the gastrointestinal side effects of opioids. Studies showed that oral methylnaltrexone prevented morphine-induced delays in gastrointestinal transit time.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

6.

The effects of methylnaltrexone alone and in combination with acutely administered codeine on gastrointestinal and colonic transit in health.

Author: WongB S, RaoA S, CamilleriM, ManabeN, McKinzieS, BusciglioI, BurtonD D, RyksM, ZinsmeisterA R

Methylnaltrexone did not affect gastrointestinal or colonic transit and did not reverse acute codeine-associated delayed gut transit in healthy individuals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Subcutaneous methylnaltrexone for treatment of acute opioid-induced constipation: phase 2 study in rehabilitation after orthopedic surgery.

Author: AnissianLucas, SchwartzHarry W, VincentKevin, VincentHeather K, CarpenitoJennifer, StamblerNancy, RamakrishnaTage

Laxation
Gastrointestinal side effects

Subcutaneous methylnaltrexone was effective and well tolerated in treating acute opioid-induced constipation (OIC) after orthopedic procedures. Patients receiving methylnaltrexone achieved laxation significantly faster than those receiving placebo.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Characterization of abdominal pain during methylnaltrexone treatment of opioid-induced constipation in advanced illness: a post hoc analysis of two clinical trials.

Author: SlatkinNeal E, LynnRichard, SuChinyu, WangWenjin, IsraelRobert J

Opioid-induced constipation treatment
Abdominal pain

Methylnaltrexone, a drug for opioid-induced constipation, was found to be associated with abdominal pain as the most common side effect.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Methylnaltrexone: its pharmacological effects alone and effects on morphine in healthy volunteers.

Author: ZacnyJames P, WroblewskiKristen, CoalsonDennis W

Opioid-induced constipation

This article reviews the use of methylnaltrexone bromide (MTNX) for opioid-induced constipation. Studies suggest that MTNX may alter other opioid-induced effects besides constipation, highlighting the potential role of peripheral opioid actions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

10.

The effects of morphine and methylnaltrexone on gastrointestinal pain in healthy male participants.

Author: BrokjaerA, OlesenA E, ChristrupL L, DahanA, DrewesA M

Opioid side effect relief
Local analgesia interference

This study explored the effect of rectal morphine before and after blocking opioid receptors outside the central nervous system with methylnaltrexone (MNTX).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

Protocol for a randomised control trial of methylnaltrexone for the treatment of opioid-induced constipation and gastrointestinal stasis in intensive care patients (MOTION).

Author: PatelParind B, BrettStephen J, O'CallaghanDavid, AnjumAisha, CrossMary, WarwickJane, GordonAnthony C

Gastrointestinal dysmotility treatment

Methylnaltrexone, a peripheral opioid antagonist, may be effective in reversing opioid-induced constipation and gastrointestinal dysmotility in intensive care patients. This trial investigates the potential benefits of methylnaltrexone in managing these common side effects of opioid sedation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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