Photo Credit: Freepick

The following is a summary of “Naldemedine Use and Healthcare Resource Utilization in Patients treated with Opioid Analgesics for Chronic Non-Cancer Pain: Results of a Real-world Study in the USA,” published in the March 2025 issue of Pain and Therapy by Vincentis et al. 

Opioid-induced constipation (OIC) affects the QoL and costs, with limited real-world data on naldemedine use, especially in older adults (OAs).  

Researchers conducted a retrospective study to describe naldemedine use in real-world settings, examining clinical characteristics, comorbidities, co-prescribed medications, and healthcare resource utilization (HCRU), with a focus on OAs, 

They analyzed data from the 2017–2022 Merative ^™ MarketScan® Commercial and Medicare Databases. A total of 2,110 naldemedine users aged ≥30 years on chronic opioid therapy were identified. Demographic and clinical characteristics, co-prescribed medications, and HCRU were assessed. A subgroup analysis was conducted for individuals aged ≥65 years.  

The results showed that 66% women with a median age of 56 years, and 14% were aged ≥65 years were included. A high comorbidity burden was observed, with hypertension in 57%, diabetes in 36%, and chronic pulmonary disease in 25%, while 38% had a Charlson Comorbidity Index ≥2. Polypharmacy, defined as the use of 5 or more distinct drugs excluding naldemedine, was common (76%, increasing to 82% in those aged ≥65 years). Naldemedine was most frequently prescribed for chronic back pain and radiculopathy. Oxycodone, hydrocodone, and morphine were the most used opioids. Following naldemedine initiation, 30% experienced reduced hospitalizations per patient per year, with a greater reduction in OAs (37%). Potential drug–drug interactions with CYP3A4 inducers or inhibitors were rare and had no apparent effect on HCRU.  

Investigators concluded that naldemedine, primarily used in middle-aged adults with comorbidities and polypharmacy, reduced HCRU, especially in OAs with OIC, demonstrating its real-world safety and effectiveness. 

Source: link.springer.com/article/10.1007/s40122-025-00720-y