OBJECTIVES: To profile the demographic and clinical characteristics of patients prescribed naldemedine for opioid-induced constipation (OIC) in the UK.

METHODS: The UK study used the Clinical Practice Research Datalink (CPRD) Aurum database. Research-quality patients prescribed naldemedine between 01/09/2020 and 20/10/2023 were selected by therapy codes. The index date was the first naldemedine prescription date. Naldemedine episodes were identified by overlapping prescriptions, and discontinuation was defined as a gap of > 56 days without renewal. Patients were followed until therapy end or censored at transfer-out date or last practice collection date. Baseline characteristics were described. Time to discontinuation was explored using a Kaplan-Meier estimate. Adherence was examined using the Medical Possession Ratio (MPR), defined as distinct days’ supply prescribed over an episode divided by the duration.

RESULTS: The study cohort included 171 patients, 62.0% female, with a mean age of 63 years. Mean Charlson Comorbidity Index was 2.7. 50.3% had a record of cancer within the year preceding treatment, and 30.0% had a record indicative of surgery during the same period. 98.2% of patients had a prescription for an opioid in the previous six months, 90.6% in the month prior, and 61.4% had a prescription for laxatives in the previous six months. Median total prescriptions during follow-up were 2 (IQR: 1-5). 56 days after treatment, more than half discontinued naldemedine. The median MPR was 100.0% (IQR: 98.5-100.5).

CONCLUSIONS: This study profiles naldemedine use in UK primary care. The majority of patients had received opioids before the initial naldemedine prescription. Over half had a record of cancer in the previous 12 months, and almost a third had a code indicative of surgery in the previous month.