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New Indication for Movantik: Cancer Survivors With Chronic Pain

August 7, 2017
Cancer survivors who have chronic pain now have a new treatment option for opioid-induced constipation, a common and sometimes debilitating side effect of opioid pain management.

The US Food and Drug Administration (FDA) has updated the indication of Movantik (naloxegol) tablets to include cancer survivors who have chronic pain that requires opioid therapy. The previous indications only included treatment of opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain, according to a press release from AstraZeneca.1

Movantik was initially approved by the FDA in 2014. It was the first once-daily oral peripherally-acting mu-opioid receptor antagonist (PAMORA) medication for the treatment of OIC.

New treatment for OIC in cancer survivors.

Opioid-induced constipation is a well-known and persistent side effect of chronic opioid use. The gastrointestinal tract contains mu opioid receptors. When a person takes an opioid, the medication binds to these receptors in the GI tract, reducing motility, causing constipation. The oral agent works by unblocking the mu-opioid receptors in the gut, allowing for return of normal bowel function.

“This label update clarifies that adult patients who have chronic pain related to prior cancer or its treatment who do not require frequent opioid dosage escalation are included within the previously approved indication of Movantik for the treatment of OIC in adults with chronic non-cancer pain,” noted the company.

With cancer treatment success comes a down side—more disability and pain. According to a recent study by Moye et al, “Pain is a significant persisting problem for 1 in 3 cancer survivors.”2 In addition, many cancer patients are living longer, making pain related to prior cancer or its treatment an important healthcare issue.

“The etiologies of cancer pain can be nociceptive [somatic and visceral], neuropathic, or mixed; and temporally may represent acute or active disease, subacute, or chronic with palliative care—or in remission with residual effects,” noted Howard Hoffburg, MD, in an article in Practical Pain Management.3

The role of the pain practitioner in cancer pain management is shifting. Improvements in minimally invasive surgical techniques, radiation therapy, and chemotherapy have left an increasing number of cancer survivors with long-lasting pain syndromes. Understanding the etiology of cancer pain is critical to improving pain control and quality of life in these vulnerable patients. The approval of an agent to manage the side effects of opioid therapy is a welcome improvement.

Last updated on: November 5, 2020
Continue Reading:
Opioid-induced Constipation: Causes and Treatments

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