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Review
. 2019 Dec 19;20(12):91.
doi: 10.1007/s11864-019-0686-6.

Opioid-Induced Constipation in Oncological Patients: New Strategies of Management

Ricard Mesía  1 , Juan Antonio Virizuela Echaburu  2 , Jose Gómez  3 , Tamara Sauri  4 , Gloria Serrano  5 , Eduardo Pujol  6
Affiliations
Review

Opioid-Induced Constipation in Oncological Patients: New Strategies of Management

Ricard Mesía et al. Curr Treat Options Oncol. .

Abstract

Cancer-associated pain has traditionally been treated with opioid analgesics, often in escalating doses. Opioid-induced constipation (OIC) is a common problem associated with chronic use of opioid analgesics. Typical treatment strategies to alleviate constipation are based on dietary changes, exercise, and laxatives. However, laxatives have a nonspecific action and do not target underlying mechanisms of OIC. This article will review prevalent, clinical presentation and recommendations for the treatment of OIC. An independent literature search was carried out by the authors. We reviewed the literature for randomized controlled trials that studied the efficacy of laxatives, naloxone, and naloxegol in treating OIC. Newer strategies addressing the causal pathophysiology of OIC are needed for a more effective assessment and management of OIC. Finally, traditional recommended therapies are appraised and compared with the latest pharmacological developments. Future research should address whether naloxegol is more efficacious by its comparison directly with first-line treatments, including laxatives.

Keywords: Cancer; Laxatives; Naloxegol; Opioid analgesics; Opioid-induced constipation; Pain.

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Conflict of interest statement

Ricard Mesía has received compensation from Merck, Bristol-Myers Squibb, MSD, Kyowa, AstraZeneca, Nanobiotix, and Roche for Service as a consultant. Juan Antonio Virizuela declares that he has no conflict of interest. Jose Gómez declares that he has no conflict of interest. Tamara Sauri declares that she has no conflict of interest. Gloria Serrano declares that she has no conflict of interest. Eduardo Pujol declares that he has no conflict of interest.

This work was supported by Kyowa Kirin Farmaceutica SLU. The authors received research funding from Kyowa Kirin Farmaceutica SLU for this colaboration.

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