GASTROINTESTINAL HORMONES: Edited by H. Christian WeberOpioid-induced constipation in chronic noncancer painWeber, H. ChristianAuthor Information Section of Gastroenterology, Boston University School of Medicine, Boston, Massachusetts, USA Correspondence to H. Christian Weber, MD, Section of Gastroenterology, Boston University School of Medicine, 650 Albany Street, EBRC, Room 508, Boston, MA 02118-2518, USA. Tel: +1 617 638 8330; fax: +1 617 638 7785; e-mail: [email protected] Current Opinion in Endocrinology & Diabetes and Obesity: February 2016 - Volume 23 - Issue 1 - p 11-17 doi: 10.1097/MED.0000000000000220 Buy Metrics Abstract Purpose of review Opioid-based management of noncancer pain has become much more prevalent over the last 2 decades and is responsible for a wide range of side-effects, particularly affecting the intestinal tract causing opioid-induced constipation (OIC). This review will consider results of recent clinical trials that have provided evidence of new pharmacological management options for the treatment of OIC. Recent findings Supportive use of conventional agents, such as stool softeners, osmotic laxatives, and stimulating laxatives in OIC has limited efficacy. The peripheral μ-opioid receptor antagonist (PAMORA) methylnaltrexone (MNTX) was first FDA approved for OIC in patients with advanced illness and later also for OIC in noncancer pain patients; clinical trial results indicated MNTX did not reverse opioid analgesia and did not trigger central opioid withdrawal. Another PAMORA, the orally available naloxegol, has also gained recent FDA approval for the treatment of OIC in adults with chronic, noncancer pain. Lubiprostone, a bicyclical fatty acid acting via activation of intestinal chloride channel-2 (ClC-2), was also approved for OIC treatment in patients with noncancer pain. Summary PAMORA MNTX and naloxegol and the intestinal chloride channel-2 (ClC-2) activator lubiprostone represent additional possible therapeutic options for the management of OIC in patients with chronic noncancer pain. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.