Lubiprostone Is Effective in the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

OBJECTIVE:

To evaluate the efficacy and safety of lubiprostone in the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C).

PATIENTS AND METHODS:

We performed a literature search of the MEDLINE, Cochrane, Google Scholar, and ClinicalTrials.gov databases (from January 1, 2005, through January 31, 2015). Relevant studies meeting the inclusion criteria were manually searched by 2 independent reviewers. Efficacy outcomes evaluated at 1 week, 1 month, and 3 months of intervention were weekly frequency of spontaneous bowel movements, severity of constipation, consistency of stools, degree of abdominal pain/discomfort, degree of straining, and abdominal bloating.

RESULTS:

Of 246 studies identified, data from 9 trials comprising 1468 patients (63.6%) in the lubiprostone group and 841 (36.4%) in the placebo group were analyzed. We found that lubiprostone treatment significantly improved the severity of constipation, stool consistency, abdominal pain, degree of straining, and abdominal bloating at 1 week (P≤.03) and 1 month (P≤.004), except for abdominal pain at 1 month, which was similar to that when treated with placebo (P=.21). At 3 months, except for abdominal bloating (P=.03), there was no difference between lubiprostone and placebo groups in all other outcomes (P≥.05). Adverse effects such as nausea, vomiting, and diarrhea were common (incidence rate, 2.4%-75%); however, the incidence of serious adverse effects was low (<5%) and was mostly unrelated to lubiprostone treatment.

CONCLUSION:

Lubiprostone is a safe and efficacious drug for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation, with limited adverse effects in 3 months of follow-up.

• Authors: Fan Li, Tao Fu, Wei-Dong Tong, Bao-Hua Liu, Chun-Xue Li, Yu Gao, Jin-Song Wu, Xiang-Feng Wang, An-Ping Zhang
• Journal: Mayo Clinic proceedings (Mayo Clin Proc) Vol. 91 Issue 4 Pg. 456-68 (Apr 2016) ISSN: 1942-5546 [Electronic] England
• PMID: 27046523 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
• Copyright: Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Chemical References

• Gastrointestinal Agents
• Laxatives
• Lubiprostone

Topics

• Abdominal Pain (drug therapy)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Chronic Disease (drug therapy)
• Constipation (drug therapy)
• Female
• Gastrointestinal Agents (therapeutic use)
• Humans
• Irritable Bowel Syndrome (drug therapy)
• Laxatives (therapeutic use)
• Lubiprostone (therapeutic use)
• Male
• Middle Aged
• Randomized Controlled Trials as Topic
• Young Adult