Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

121 questions · 121 findings · 7 reviews · Pain, Palliative and Supportive Care

No studies found 50 · 41.3%GRADE not reported 4 · 3.3%Very low 24 · 19.8%Low 36 · 29.8%Moderate 6 · 5%High 1 · 0.8%

Lower‐dose methylnaltrexone vs higher dose

Symptoms of opioid withdrawal in the medium term · people receiving palliative care irrespective of whether they had cancer with opioid‐induced bowel dysfunction

Methylnaltrexone lower dose showed no clear difference in symptoms of opioid withdrawal in the medium term compared with higher dose (low certainty).

1 finding from 1 review

Lower‐dose methylnaltrexone vs higher dose

Adverse events · people receiving palliative care irrespective of whether they had cancer with opioid‐induced bowel dysfunction

Methylnaltrexone lower dose showed no clear difference in adverse events compared with higher dose (low certainty).

1 finding from 1 review

Naldemedine vs placebo

Symptoms of opioid withdrawal in the medium term · people with cancer irrespective of whether receiving palliative care and with opioid‐induced bowel dysfunction

It is very uncertain whether naldemedine changes symptoms of opioid withdrawalein the medium termc compared with placebo (very low certainty).

1 finding from 1 review

Naldemedine vs placebo

Serious adverse eventsh · people with cancer irrespective of whether receiving palliative care and with opioid‐induced bowel dysfunction

Naldemedine showed no clear difference in serious adverse eventsh compared with placebo (low certainty).

1 finding from 1 review

Low dose naldemedine vs higher dose

Laxation response: risk of spontaneous rescue‐free bowel movements in the short terma · people with cancer irrespective of whether receiving palliative care and with opioid‐induced bowel dysfunction

The review found no eligible studies for this question.

1 finding from 1 review

Low dose naldemedine vs higher dose

Laxation response: risk of spontaneous rescue‐free bowel movements in the medium termb · people with cancer irrespective of whether receiving palliative care and with opioid‐induced bowel dysfunction

Low dose naldemedine may leads to lower laxation response: risk of spontaneous rescue‐free bowel movements… compared with higher doses (low certainty).

1 finding from 1 review

Low dose naldemedine vs higher dose

Laxation response: patient assessment of change in bowel status at the end of trial · people with cancer irrespective of whether receiving palliative care and with opioid‐induced bowel dysfunction

The review found no eligible studies for this question.

1 finding from 1 review

Summary of findings table ‐ Kappa‐opioid agonists vs placebo

Risk for at least one adverse drug reaction (ADR) per participant · patients with chronic kidney disease (CKD) pruritus

Summary of findings table ‐ Kappa‐opioid agonists may leads to higher risk for at least one adverse drug reaction (ADR) per patient compared with placebo (low certainty).

1 finding from 1 review