Effectiveness of Naloxegol in Patients with Cancer Pain Suffering from Opioid-induced Constipation

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2021 Jun 13

PMID 34120247

Citations 6

Authors

Antoine Lemaire

Yoann Pointreau

Berengere Narciso

Francois-Xavier Piloquet

Viorica Braniste

Jean-Marc Sabate

Affiliations

Soon will be listed here.

Abstract

Purpose: Naloxegol, an oral once-daily peripherally acting mu-opioid receptor antagonist, is indicated for the treatment of opioid-induced constipation (OIC) with inadequate response to laxative(s), in cancer and non-cancer patients. This study mainly aimed to assess in real-life conditions the efficacy and safety of naloxegol in cancer pain patients and the evolution of their quality of life.

Methods: A non-interventional, 4-week follow-up study was conducted in 24 French oncology and pain centers between 2018 and 2019. Eligible patients were aged ≥ 18 years, treated with opioids for cancer pain, and started naloxegol for OIC with inadequate response to laxatives. The rate of the response to naloxegol (primary criterion) was assessed at W4. The evolution of quality of life was measured using the Patient Assessment of Constipation Quality of Life (PAC-QOL).

Results: A total of 124 patients were included (mean age, 62 ± 12 years; ECOG ≤ 2, 79%; primary cancer, lung 18%, breast 16%, prostate 11%, head and neck 9%, digestive 9%…; metastatic stage, 80%). At inclusion, the median opioid dosage was 60 mg of oral morphine or equivalent. At W4, the response rate was 73.4% (95% CI [63.7-83.2%]), and 62.9% (95% CI [51.5-74.2%]) of patients had a clinically relevant change in quality of life (decrease in PAC-QOL score ≥ 0.5 point). Adverse events related to naloxegol were reported in 8% of patients (7% with gastrointestinal events; one serious diarrhea).

Conclusion: This real-world study shows that naloxegol is effective and well tolerated in cancer pain patients with OIC and that their quality of life improves under treatment.

Citing Articles

Naloxegol for the Treatment of Opioid-Induced Constipation in Patients with Cancer Pain: A Pooled Analysis of Real-World Data.

Sabate J, Beato-Zambrano C, Cobo M, Lemaire A, Montesarchio V, Serna-Montros J Cancers (Basel). 2025; 17(5).

PMID: 40075711 PMC: 11898930. DOI: 10.3390/cancers17050865.

A Systematic Review of Naldemedine and Naloxegol for the Treatment of Opioid-Induced Constipation in Cancer Patients.

Braun U, Jackson L, Garcia M, Imam S Pharmacy (Basel). 2024; 12(2).

PMID: 38525728 PMC: 10961755. DOI: 10.3390/pharmacy12020048.

A Retrospective Study of the Efficacy and Safety of Naldemedine for Treatment of Opioid-Induced Constipation in Patients with Hepatobiliary Pancreatic Cancer.

Kamiya T, Imai H, Fujita Y, Hiruta E, Masuno T, Yamazaki S Medicina (Kaunas). 2023; 59(3).

PMID: 36984494 PMC: 10051263. DOI: 10.3390/medicina59030492.

A retrospective study of the efficacy and safety of naldemedine for opioid-induced constipation in thoracic cancer patients.

Imai H, Fujita Y, Hiruta E, Masuno T, Yamazaki S, Tanaka H Thorac Cancer. 2022; 13(16):2301-2308.

PMID: 35790500 PMC: 9376157. DOI: 10.1111/1759-7714.14557.

Efficacy and Safety of Naldemedine for Patients with Cancer with Opioid-Induced Constipation in Clinical Practice: A Real-World Retrospective Study.

Nishiba H, Imai H, Fujita Y, Hiruta E, Masuno T, Yamazaki S J Clin Med. 2022; 11(9).

PMID: 35566798 PMC: 9102706. DOI: 10.3390/jcm11092672.

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