Several
secretagogues, such as
lubiprostone, have been developed for the treatment of
constipation in the last 10 years. It is unclear whether the efficacy of
lubiprostone for spontaneous bowel movement (SBM) and the adverse events are similar between idiopathic and
opioid-induced constipation and between East-Asian and Western populations. We conducted a meta-analysis to compare efficacy and safety of
lubiprostone in two populations with idiopathic vs
opioid-induced constipation. The PubMed and Cochrane databases were searched for relevant randomized control trials (RCTs) investigating the efficacy and safety that were published in English up to March 2019. Compared with the placebo groups in idiopathic and
opioid-induced constipation, the
lubiprostone groups significantly improved in 24-h SBM frequency [relative risk: 1.28, 95% confidence interval, 1.11-1.49, and 1.23, 1.14-1.32] and weekly frequency >3 SBM/week (1.68, 1.41-2.01, and 1.43, 1.01-2.04), respectively. Although the incidence of adverse events was similar between idiopathic and
opioid-induced constipation, the incidence of
nausea in Western populations with idiopathic
constipation was significantly higher (29.2%) than that in East-Asian populations (10.0%, p<0.001). In conclusion,
lubiprostone effectively improved SBM frequency, irrespective of the etiology of
constipation and population. The incidence of
nausea was significantly higher in Western populations.