Assessing the efficacy of peripherally acting {micro}-opioid receptor antagonists (PAMORAs) in the treatment of opioid-induced constipation: authors reply

We thank Chedid and Camilleri for their carefully composed letter,1 and are delighted to have provoked further debate about the relative efficacy of drugs acting on µ-opioid receptors in the treatment of opioid-induced constipation (OIC) with our network meta-analysis.2 In fact, we had also written to another journal concerning a recent network meta-analysis examining this issue,3 which had reported erroneously that subcutaneous methylnaltrexone appeared to perform better than other medications for OIC.4 The authors confirmed in their reply to our letter that they had mistakenly included redundant data from duplicate publications of the same two randomised-controlled trials (RCTs) of methylnaltrexone in this meta-analysis,5 likely accounting for their findings.4

In response to the specific issues raised by Chedid and Camilleri,1 first as we reported in the supplementary materials section of our manuscript there were no significant differences in rates...

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