J Thomas

Dr J Thomas, San Diego Hospice and Palliative Care, San Diego, CA, USA; jthomas@sdhospice.org

STUDY DESIGN

Design:

randomised placebo controlled trial.

Allocation:

unclear allocation concealment.*

Blinding:

blinded (patients, healthcare providers, and outcome assessors).*

STUDY QUESTION

Setting:

27 nursing homes, hospice sites, and palliative care centres in the USA and Canada.

Patients:

133 patients ⩾18 years of age (median age 71 y, 57% women) who had terminal illness with life expectancy ⩾1 month, were receiving opioids for analgesia, and had opioid-induced constipation (<3 laxations in the previous wk or no laxation in the previous 48 h, despite having taken laxatives for ⩾3 d).

Intervention:

subcutaneous methylnaltrexone, 0.15 mg/kg body weight (n = 62), or placebo (n = 71) every other day for 2 weeks. Laxatives could be taken as needed but not within 4 hours of the study drug. …