{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:33:08Z","timestamp":1790289188810,"version":"4.1.0"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T00:00:00Z","timestamp":1591142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the efficacy and safety of peripherally acting mu-opioid receptor antagonists (PAMORAs) for the treatment of opioid-induced constipation (OIC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Randomized controlled trials (RCTs) were searched for OIC therapy comparing PAMORAs with placebo. Both a pairwise and network meta-analysis were performed. The surface under the cumulative ranking area (SUCRA) was used to determine the efficacy and safety of OIC treatment using different PAMORAs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The primary target outcome was a response that achieves an average of three or more bowel movements (BMs) per week. In the network meta-analysis, four PAMORAs (naldemedine, naloxone, methylnaltrexone, and alvimopan) showed a better BM response than the placebo. Naldemedine was ranked first (odds ratio [OR]\u2009=\u20092.8, 95% credible interval [CrI] = 2\u20134.5, SUCRA = 89.42%), followed by naloxone (OR\u2009=\u20092.9, 95% CrI = 1.6\u20135.3, SUCRA = 87.44%), alvimopan (OR\u2009=\u20092.2, 95% CrI = 1.3\u20133.5, SUCRA = 68.02%), and methylnaltrexone (OR\u2009=\u20091.7, 95% CrI = 1.0\u20132.8, SUCRA = 46.09%). There were no significant differences in safety found between the PAMORAs and the placebo.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found that PAMORAs are effective and can be safely used for the treatment of OIC. In network meta-analysis, naldemedine and naloxone appear to be the most effective PAMORAs for the treatment of OIC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaa152","type":"journal-article","created":{"date-parts":[[2020,4,18]],"date-time":"2020-04-18T19:07:24Z","timestamp":1587236844000},"page":"3224-3232","source":"Crossref","is-referenced-by-count":13,"title":["Efficacy and Safety of Peripherally Acting Mu-Opioid Receptor Antagonists for the Treatment of Opioid-Induced Constipation: A Bayesian Network Meta-analysis"],"prefix":"10.1093","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1217-5521","authenticated-orcid":false,"given":"Rong","family":"Ouyang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China"},{"name":"Department of Gastroenterology, Liuzhou Worker\u2019s Hospital, Liuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongzhuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Liuzhou Worker\u2019s Hospital, Liuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shijiang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Liuzhou Worker\u2019s Hospital, Liuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0431-1888","authenticated-orcid":false,"given":"Jiean","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, 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