Objective: To summarize results from pain and opioid use assessments with naloxegol in adults with opioid-induced constipation (OIC) and chronic noncancer pain. Methods: Two phase 3 randomized, double-blind, 12-week studies evaluated the efficacy and safety of oral naloxegol (12.5 or 25 mg daily) in adults (18 to < 85 years) with confirmed OIC and chronic noncancer pain: KODIAC-04 (NCT01309841) and KODIAC-05 (NCT01323790). Pain level was assessed daily (11-point numeric rating scale [NRS]; 0 = no pain, 10 = worst imaginable pain). Changes from baseline in mean weekly pain scores and opioid dose (weeks 1 through 12) were analyzed using mixed-model repeated measures.Results: At baseline, mean daily NRS average pain scores ranged from 4.5 to 4.8 for all groups in KODIAC-04 (N = 652) and were 4.6 for each group in KODIAC-05 (N = 700). Respective mean AE SD changes from baseline average pain for placebo, naloxegol 12.5 mg, and naloxegol 25 mg were À0.2 AE 1.07, À0.3 AE 1.05 (P = 0.773 vs. placebo), and 0.2 AE 0.95 (P = 0.837 vs. placebo; KODIAC-04) and À0.1 AE 0.94, À0.1 AE 0.87 (P = 0.744), and 0.0 AE 1.18 (P = 0.572; KODIAC-05). At baseline, mean daily opioid doses ranged from 135.6 to 143.2 morphine equivalent units (MEUs)/day in KODIAC-04, and from 119.9 to 151.7 MEUs/day in KODIAC-05. Respective mean AE SD changes from baseline dose were À1.8 AE 30.19, À2.3 AE 20.52 (P = 0.724 vs. placebo), and 0.4 AE 13.01 (P = 0.188 vs. placebo; KODIAC-04) and À0.3 AE 17.14, À1.3 AE 17.11 (P = 0.669 vs. placebo), and 0.1 AE 8.54 (P = 0.863 vs. placebo; KODIAC-05). Changes in maintenance opioid dose were few; reasons for such changes were similar across treatment groups. Conclusion: Centrally mediated opioid analgesia was maintained during treatment with naloxegol in patients with noncancer pain and OIC. &