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Frank Peacock, MD: Reducing the Cost of Opioid-Induced Constipation

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Frank Peacock explains how methylnaltrexone can prevent patients with opioid-induced constipation from being hospitalized.

Methylnaltrexone (Relistor) was found to be more effective than laxative theraapy for treating patients who are experiencing pain due to opioid-induced constipation (OIC).

The study, "First-Dose Efficacy of Methylnaltrexone in Patients with Severe Medical Illness and Opioid-Induced Constipation: A Pooled Analysis" was recently published in The Journal of Emergency Medicine.

In an interview with HCPLive®, Frank Peacock, MD, Professor, Research Director and Vice Chair for Research at Baylor College of Medicine, explained that rescue-free laxation (RFL) was acheived in the majority of patients who were given methylnaltrexone and the pain management effect of the opioid was maintained.

For individuals with severe medical illnesses, like cancer, long-term opioid use is necessary for managing their pain. Unfortunately, opioid-induced constipation is a prevalent and debilitating adverse event.

"Most anybody who works in the ER is familiar with this," Peacock said.

In many cases, individuals experiencing opioid-induced cosntipation are taking opoids for a chronic or severe illness and are immunocompromised. So, if they're admitted to the emegency department (ED), the goal is to keep them from being hospitalized and further exposed.

It's for this reason that the study focused on what can be done within 4 hours. Methylnaltrexone displayed quicker results when compared to laxative therapy.

Another reason to avoid hospitalizing a patient, Peacock mentioned, is the financial savings that are spared when you can resolve an issue like opioid-induced constipation right in the emergency department.

"So, I think that there is more that's going to come on this," Peacock said, "in terms of the healthcare economic outcome, consequences of being able to treat people acutely for a disease that we historically didn't have the ability to treat them acutely."


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