We read with great interest the systematic review and network meta-analysis on pharmacological treatments for opioid-induced constipation (OIC).1 Based on 27 randomised controlled trials (RCTs, 9149 patients), the authors concluded that peripherally acting mu-opioid receptor antagonists (PAMORAs) and the prokinetic prucalopride were all more effective than placebo for OIC and that naloxone and naldemedine were the most efficacious ones.1 We have previously documented that OIC has high prevalence and is associated with reduced quality of life (QoL) in opioid-addicted patients treated with opioid substitution treatment (OST).2 Overweight is also common and interventions for weight loss are recommended in patients under OST.3 Orlistat, a weight-control drug that inhibits lipase, thereby decreasing fat absorption from the intestinal lumen, has been reported to improve drug-resistant constipation in small case series,4 5 and clozapine-induced constipation in a small RCT.6 In an open-label observational study, we explored whether orlistat may improve OIC in OST patients. From a cohort of 1057 heroin-dependent patients under OST previously reported,2 we recruited patients with OIC, who were prescribed orlistat 60 mg three times a day for weight reduction. OIC was measured with …

中文翻译：

---

阿片类药物引起的便秘的药物治疗：迈向新的目标

据报道，在小型病例系列研究中，4 5 和氯氮平引起的便秘在小型随机对照试验中可改善耐药性便秘。6 在一项开放标签观察性研究中，我们探讨了奥利司他是否可以改善 OST 患者的 OIC。从先前报道的 OST 下的 1057 名海洛因依赖患者队列中，2 我们招募了 OIC 患者，他们每天服用 3 次奥利司他 60 毫克以减轻体重。OIC 是用……测量的