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Go with SYMPROIC®: Proven efficacy for OIC

SYMPROIC is the only PAMORA with both a strong recommendation and high quality of evidence from the American Gastroenterological Association.3


SYMPROIC was studied in two 12-week clinical trials and a 52-week safety study. Learn more about each study below.

Go with SYMPROIC®: Proven efficacy for OIC

SYMPROIC is the only PAMORA with both a strong recommendation and high quality of evidence from the American Gastroenterological Association.3


SYMPROIC was studied in two 12-week clinical trials and a 52-week safety study. Learn more about each study below.

SYMPROIC clinical trials included >1000 patients with OIC

Two replicate, 12-week, randomized, double-blind, placebo-controlled trials2,6Chart showing randomization used in study
Patient demographics2,6Chart showing patient demographics of those included in study
Study population2,6
  • Eligible patients received a stable opioid morphine equivalent daily dose of at least 30 mg for 4 weeks or more before enrollment and self-reported OIC
  • OIC was confirmed through a 2-week run-in period and was defined as no more than 4 SBMs over 14 consecutive days and fewer than 3 SBMs in a given week, with at least 25% of the SBMs associated with one or more of the following conditions: (1) straining, (2) hard or lumpy stools, (3) having a sensation of incomplete evacuation, or (4) having a sensation of anorectal obstruction/blockage. SBM was defined as a BM without rescue laxative taken within the past 24 hours
  • Patients were not using laxatives or were willing to discontinue laxatives
  • Patients were excluded if they had no BMs over the 7 consecutive days before and during the 2-week screening period; patients who had never taken laxatives were excluded, as well as those with evidence of significant structural abnormalities of the gastrointestinal tract

Proven efficacy in two 12-week clinical trials

Responder rates were significantly higher with SYMPROIC than with placebo2,6Chart of Primary Endpoint for responder rate
Primary Endpoint: Responder rate2,6Chart showing responder rate outcomes in two studies vs placebo

Patients taking SYMPROIC had SBMs more frequently, more completely, and without straining compared to placebo2,6

More frequent SBMs with SYMPROIC

Frequency of SBMs per week from baseline to the first week2,6Chart showing frequency of SBMs against baseline after 1 week on Symproic vs placebo

Statistically significant increase in frequency of SBMs per week from baseline to Week 1 vs placebo2,6

Statistically significant increase in frequency of SBMs per week from baseline to the last 2 weeks vs placebo2,6

Frequency of SBMs per week from baseline to the last 2 weeksChart showing frequency of SMBs against baseline after 2 weeks on Symproic vs placebo

More complete SBMs with SYMPROIC

Frequency of CSBMsChart showing frequency of CSBMs in last two weeks of study

Statistically significant increase in frequency of complete SBMs (CSBMs) per week from baseline to the last 2 weeks vs placebo2,6

More SBMs without straining with SYMPROIC

Statistically significant increase in frequency of SBMs without straining per week from baseline to the last 2 weeks vs placebo2,6

Frequency of SBMs without straining Chart showing frequency of SBMs without straining in the last two weeks of study

SYMPROIC is the only OIC therapy with a both strong recommendation and high quality of evidence from the American Gastroenterological Association3

Proven long-term efficacy and tolerability

Significant and sustained increase in bowel movements from baseline vs placebo over 52 weeks1,2Chart plotting significant and sustained increase in bowel movements from baseline vs placebo over 52 weeks

SYMPROIC is the only PAMORA with a double-blind, placebo-controlled, long-term safety study2

SYMPROIC had low rates of abdominal pain across 3 studies1,2,6

INDICATION

SYMPROIC® (naldemedine) is indicated for the treatment of opioid-induced constipation (OIC) in adult patients 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.

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

  • Patients with known or suspected gastrointestinal (GI) obstruction and patients at increased risk of recurrent obstruction, due to the potential for GI perforation.
  • Patients with a history of a hypersensitivity reaction to naldemedine. Reactions have included bronchospasm and rash.
INDICATION

SYMPROIC® (naldemedine) is indicated for the treatment of opioid-induced constipation (OIC) in adult patients 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.

Important Safety Information
CONTRAINDICATIONS
  • Patients with known or suspected gastrointestinal (GI) obstruction and patients at increased risk of recurrent obstruction, due to the potential for GI perforation.
  • Patients with a history of a hypersensitivity reaction to naldemedine. Reactions have included bronchospasm and rash.
WARNINGS AND PRECAUTIONS

Cases of GI perforation have been reported with use of another peripherally acting opioid antagonist in patients with conditions that may be associated with localized or diffuse reduction of structural integrity in the wall of the GI tract. Monitor for the development of severe, persistent, or worsening abdominal pain; discontinue if this symptom develops.

Symptoms consistent with opioid withdrawal, including hyperhidrosis, chills, increased lacrimation, hot flush/flushing, pyrexia, sneezing, feeling cold, abdominal pain, diarrhea, nausea, and vomiting have occurred in patients treated with SYMPROIC.

Patients having disruptions to the blood-brain barrier may be at increased risk for opioid withdrawal or reduced analgesia. Take into account the overall risk-benefit profile when using SYMPROIC in such patients. Monitor for symptoms of opioid withdrawal in such patients.

DRUG INTERACTIONS

Avoid use with strong CYP3A inducers (e.g., rifampin) because they may reduce the efficacy of SYMPROIC.

Use with moderate (e.g., fluconazole) and strong (e.g., itraconazole) CYP3A inhibitors and P-glycoprotein inhibitors (e.g., cyclosporine) may increase SYMPROIC concentrations. Monitor for potential adverse reactions.

Avoid use of SYMPROIC with another opioid antagonist due to the potential for additive effect and increased risk of opioid withdrawal.

USE IN SPECIFIC POPULATIONS

Naldemedine crosses the placenta and may precipitate opioid withdrawal in a fetus due to the immature fetal blood-brain barrier. SYMPROIC should be used during pregnancy only if the potential benefit justifies the potential risk. Because of the potential for serious adverse reactions, including opioid withdrawal in breastfed infants, a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.

Avoid use in patients with severe hepatic impairment. No dose adjustment of SYMPROIC is required in patients with mild or moderate hepatic impairment.

ADVERSE REACTIONS

The most common adverse reactions with SYMPROIC compared to placebo in two pooled 12-week studies were: abdominal pain (8% vs 2%), diarrhea (7% vs 2%), nausea (4% vs 2%), and gastroenteritis (2% vs 1%).

The incidence of adverse reactions of opioid withdrawal in two pooled 12-week studies was 1% (8/542) for SYMPROIC and 1% (3/546) for placebo. In a 52-week study, the incidence was 3% (20/621) for SYMPROIC and 1% (9/619) for placebo.

Please see Full Prescribing Information and Medication Guide for SYMPROIC.

To report SUSPECTED ADVERSE REACTIONS, contact BioDelivery Sciences International, Inc. at 1-800-469-0261 or FDA at 1‑800‑FDA‑1088 or www.fda.gov/medwatch.

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