Risk of Major Adverse Cardiovascular Events for Naldemedine & Other Medications for Opioid Induced Constipation

Inclusion Criteria:

• At least one dispensing of naldemedine or lubiprostone or naloxegol without prioruse in the database of either medication (index date)

• At least two dispensings of opioids within six months prior to and including theindex date, with at least a combined 31 cumulative days supply

• At least 18 years of age or older on the index date

• At least six months of continuous health plan coverage that includes medical andpharmacy benefits prior to and including the index date

Exclusion Criteria:

• Any acute MACE (non-fatal MI or non-fatal stroke) within six months before or on theindex date

• Any cancer treatment or cancer pain diagnosis within six months before or on theindex date

• Prior use of methylnaltrexone, alvimopan or naloxegol within six months before or onthe index date