Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis

@article{Luthra2013EfficacyOP,
  title={Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and network meta-analysis},
  author={Pavit Luthra and Nicholas Ewin Burr and Darren M. Brenner and Alexander Charles Ford},
  journal={Gut},
  year={2013},
  volume={68},
  pages={434 - 444}
}
Objective Opioids are increasingly prescribed in the West and have deleterious GI consequences. Pharmacological therapies to treat opioid-induced constipation (OIC) are available, but their relative efficacy is unclear. We performed a systematic review and network meta-analysis to address this deficit in current knowledge. Design We searched MEDLINE, EMBASE, EMBASE Classic and the Cochrane central register of controlled trials through to December 2017 to identify randomised controlled trials… 

Pharmacological and non-pharmacological treatments for opioid-induced constipation

This study will provide a comprehensive evidence on the effectiveness and safety of pharmacological and non-pharmacological treatments for opioid-induced constipation.

Pharmacological treatment of opioid-induced constipation: moving ahead to new targets

The authors concluded that peripherally acting mu-opioid receptor antagonists (PAMORAs) and the prokinetic prucalopride were all more effective than placebo for OIC and that naloxone and naldemedine were the most efficacious ones.

Safety and efficacy of naldemedine in cancer patients with opioid-induced constipation: a pooled, subgroup analysis of two randomised controlled studies

It is demonstrated that naldemedine appeared to benefit patients with OIC and cancer, irrespective of baseline characteristics, and did not seem to affect analgesia or withdrawal–even in patients with potential BBB disruptions.

Assessing the efficacy of peripherally acting mu-opioid receptor antagonists (PAMORAs) in the treatment of opioid-induced constipation

The authors concluded that naloxone was the best drug in patients with OIC, followed by naldemedine, and several factors impacted the appraisal of relative efficacy.

Effectiveness of management strategies for uninvestigated dyspepsia: systematic review and network meta-analysis

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Efficacy and Safety of Peripherally Acting Mu-Opioid Receptor Antagonists for the Treatment of Opioid-Induced Constipation: A Bayesian Network Meta-analysis.

It is found that PAMORAs are effective and can be safely used for the treatment of OIC and in network meta-analysis, naldemedine and naloxone appear to be the most effective PAMorAs for the Treatment of Oic.

Management of Opioid-Induced Constipation and Bowel Dysfunction: Expert Opinion of an Italian Multidisciplinary Panel

An Italian multidisciplinary panel on the management of opioid-induced constipation (OIC) and bowel dysfunction concludes that a comprehensive prevention and management strategy for OIC should include interventions that aim to improve fibre and fluid intake, increase mobility or exercise, and restore bowel function without compromising pain control.

Naldemedine for the treatment of opioid-induced constipation in adults with chronic noncancer pain.

Based on available data, naldemedine appears to be an effective and safe first-line therapy for the treatment of opioid-induced constipation in adults with chronic noncancer pain.

The role of naldemedine in the treatment of patients with opioid-induced constipation

  • W. Leppert
  • Medicine, Biology
    Palliative Medicine in Practice
  • 2019
Naldemedine has proven efficacy superior to placebo in the treatment of OIC in both cancer and non-cancer patients while improving patient-reported constipation symptoms and patients’ QoL and may be safely used in patients with renal failure and mild to moderate hepatic impairment.

Effectiveness of different acupuncture courses for functional constipation

The results of this network meta-analysis may help doctors determine the best treatments for patients to manage FC through comparing and arranging the comparative efficacy of different acupuncture treatments for FC.

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