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N-methylnaltrexone bromide

Phase 3FDA approved 2008

Constipation | Small molecule | Gastrointestinal |Bausch Health Companies Inc.|Trials Updated: Aug 20, 2020

N-methylnaltrexone bromide development status

FDA approval Apr 24, 2008 as Relistor
Approval holderSalix Pharms
ApplicationNDA021964
Highest phase Phase 3

Label indication • RELISTOR is an opioid antagonist. RELISTOR tablets and RELISTOR injection are indicated for the treatment of opioid-induced constipation (OIC) in adults with chronic non-cancer pain, including patients with chronic pain related to prior cancer or its treatment who do not require frequent (e.g., weekly) opioid dosage escalation.

N-methylnaltrexone bromide target and mechanism

ModalitySmall molecule

Also known as N-methylnaltrexone bromide (MOA-728), Relistor

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials3
Total Enrollment1,622

FDA Designations

No designations recorded

N-methylnaltrexone bromide clinical trials

N-methylnaltrexone bromide · 3 trials · 1 indication

Phase 3 2Phase 2 1
NCT00804141Study Evaluating Long-Term Safety of MOA-728 in Participants With Opioid-Induced ConstipationConstipation
COMPLETED1,040 Analytics
NCT00529087Study Evaluating Subcutaneous MOA-728 for the Treatment of Opioid-Induced Constipation (OIC) in Subjects With Chronic Non-Malignant PainConstipation
COMPLETED460 Analytics
PHASE3COMPLETED
Study Evaluating Long-Term Safety of MOA-728 in Participants With Opioid-Induced Constipation
ConstipationUnlock trial analytics
PHASE3COMPLETED
Study Evaluating Subcutaneous MOA-728 for the Treatment of Opioid-Induced Constipation (OIC) in Subjects With Chronic Non-Malignant Pain
ConstipationUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Baseline up to Week 50

Adverse event (AE) was defined as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug. Serious adverse events (SAEs) included death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized the participant and required medical intervention to prevent 1 of the outcomes listed in this definition. TEAEs were defined as an AE that emerged during the treatment period. Any TEAEs included both treatment-emergent SAEs and non-serious AEs. A summary of serious and all other non-serious AEs regardless of causality is located in the Reported Adverse Events module.

Percentage of Patients Having a Rescue-free Bowel Movement (RFBM) Within 4 Hours of the First Dose
up to 4 hours

A rescue-free bowel movement was defined as a bowel movement where no laxatives were used during the prior 24 hours. Information on laxative use, bowel movements and bowel movement assessments were self reported daily by the patient using a telephone interactive voice response system (IVRS).

Percentage of Active Injections Resulting in Any Rescue-free Bowel Movement (RFBM) Within 4 Hours of Injection During the Double-blind Period
4 weeks

A rescue-free bowel movement was defined as a bowel movement where no laxatives were used during the prior 24 hours. Information on laxative use, bowel movements and bowel movement assessments were self reported daily by the patient using a telephone interactive voice response system (IVRS). Active injections are those that contain study drug (e.g., daily injections in MOA-728 QD treatment group and every other injection for the MOA-728 QOD treatment group). The corresponding injections in the placebo group were used as controls.

Percentage of Participants With a Spontaneous Bowel Movement (SBM) Within 1, 2, 3, 4, and 6 Hours of Treatment
6 hours

Secondary Endpoints

Change From Baseline in Weekly Bowel Movement (BM) Rate Through Follow-up
Baseline, follow-up (14 days [Week 49 to 50])
Time to the First Rescue-free Bowel Movement (RFBM) After First Dose
up to 24 hours
Change From Baseline in Weekly Number of Rescue-free Bowel Movements (RFBM) for the Double-blind Period at 4 Weeks
Baseline and 4 weeks
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
MOA-728 12 mg QDEXPERIMENTALParticipants will receive MOA-728 12 milligrams (mg) SC once daily (QD) for 48 weeks. Dosing could be adjusted to an as needed (PRN) basis with a minimum 1 dose per week and maximum 1 dose per day.
1PLACEBO_COMPARATOR -
2EXPERIMENTAL -
3EXPERIMENTAL -
PlaceboPLACEBO_COMPARATOR -
150 mgEXPERIMENTAL -
300 mgEXPERIMENTAL -
450 mgEXPERIMENTAL -
600 mgEXPERIMENTAL -

Interventions

NameTypeDescription
N-methylnaltrexone bromide (MOA-728)DRUGMOA-728 will be administered as per the dose and schedule specified in the arm.
placeboOTHERplacebo
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites120

Inclusion Criteria: * Men and women 18 years or older. * A history of pain of at least 2 months duration before the screening visit due to documented underlying nonmalignant condition. * A history of constipation due to opioid use during 1 month before the screening visit. Exclusion Criteria: * A...

Countries:United StatesAustraliaCanadaColombiaSouth KoreaSpain
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Competitive Landscape -Constipation 3 trials

No competing companies are currently tracked in active development for Constipation.
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Frequently asked questions about N-methylnaltrexone bromide

What is N-methylnaltrexone bromide?

N-methylnaltrexone bromide is an investigational small molecule being developed for constipation, including opioid-induced constipation. It is a peripherally restricted opioid receptor antagonist. Bausch Health Companies Inc. (BHC) is developing it, and it has completed Phase 3 clinical trials.

What is N-methylnaltrexone bromide used for?

N-methylnaltrexone bromide is being developed for the treatment of constipation, specifically opioid-induced constipation in patients with chronic non-malignant pain. It is an investigational therapy and has not been approved by the FDA for any indication.

Who makes N-methylnaltrexone bromide?

N-methylnaltrexone bromide is being developed by Bausch Health Companies Inc., which trades under the ticker BHC. The company is responsible for its clinical development program.

What phase is N-methylnaltrexone bromide in?

N-methylnaltrexone bromide is in Phase 3 clinical development. It is an investigational drug and has not been approved by the FDA. Three trials have been completed, including two Phase 3 studies and one Phase 2 study.

What clinical trials is N-methylnaltrexone bromide in?

N-methylnaltrexone bromide has been studied in three completed trials: NCT00804141, a Phase 3 long-term safety study in opioid-induced constipation; NCT00547586, a Phase 2 oral study in opioid-induced bowel dysfunction; and NCT00529087, a Phase 3 subcutaneous study in opioid-induced constipation.

Is N-methylnaltrexone bromide the same as MOA-728?

Yes, N-methylnaltrexone bromide is also known as MOA-728. MOA-728 is the development code used in clinical trial titles, such as the Phase 3 study NCT00804141 evaluating long-term safety in participants with opioid-induced constipation.