Effect of linaclotide in irritable bowel syndrome with constipation (<scp>IBS</scp>‐C): a systematic review and meta‐analysis

Atluri, Dileep; Chandar, Apoorva K.; Bharucha, Adil E.; Falck‐Ytter, Yngve

doi:10.1111/nmo.12292

Cited by 61 publications

(34 citation statements)

References 29 publications

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“…Moreover, the expected cost of approximately $12/day may be prohibitive [19]. Similar data from a recent systematic review and metaanalysis of linaclotide in IBS-C found that linaclotide reduces the number of failures to achieve symptom relief by 165/1000 patients compared to placebo; nevertheless 31/1000 patients discontinued therapy due to severe diarrhea [20]. In a recent review of IBS-C and CIC studies, diarrhea experienced while taking linaclotide led to study withdrawal in 4.5-5.7% of patients compared to 0.2-0.3% in placebo groups.…”

supporting

confidence: 50%

Analysis of Nausea in Clinical Studies of Lubiprostone for the Treatment of Constipation Disorders

Gotfried

Schey

2017

Dig Dis Sci

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supporting

confidence: 50%

Analysis of Nausea in Clinical Studies of Lubiprostone for the Treatment of Constipation Disorders

Gotfried

Schey

2017

Dig Dis Sci

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“…Based on the clinical trials and meta-analyses that compared linaclotide to placebo (122,123) both in patients with IBS-C (RR: 1.95; 95% CI: 1.3-2.9, based on 7 studies) and in patients with FC (RR: 4.26; 95% CI: 2.80-6.47, based on 3 studies), linaclotide is clearly effective for relieving constipation symptoms with a NNT of 7 (95% CI: 5-11) (122) in both groups, with highly homogeneous results across studies. Linaclotide effects not only target constipation but also improve pain and distension in both groups (FC, IBS-C) as seen in clinical trials (benefit of 15-30% over placebo).…”

Section: Efficacymentioning

confidence: 99%

“…Linaclotide is the drug of choice for patients with constipation and abdominal complaints such as pain and distension when dietary fiber and laxatives have failed (122,123).…”

Section: Practical Recommendationsmentioning

confidence: 99%

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult

Mearin¹,

Ciriza²,

Mínguez³

et al. 2016

Rev Esp Enferm Dig

104

151

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In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antidepressants, psychological therapy, acupuncture, enemas, sacral root neurostimulation, surgery) are discussed, and practical recommendations are made regarding each of them.

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“…Après une commercialisation dans certains pays, aucun au sein de l'union européenne, ces molécules ont été rapidement retirées compte tenu de l'apparition d'effets indésira-bles graves avec quelques cas de décès. Depuis, le linaclotide, un agoniste de la guanilate cyclase, a montré un effet significatif chez les patients ayant des TFI à constipation prédominante [23] avec un profil de tolérance satisfaisant, cette molécule ayant une action locale. Cependant, bien qu'ayant obtenu une autorisation de mise sur le marché européen, cette molécule n'est pas commercialisée en France en raison du refus donné au remboursement pour le prix demandé par le laboratoire, bien loin de celui des anti-TNF ou des nouvelles molécules pour le traitement pour l'hépatite C. Ceci est aussi vrai pour le prucalopride, utilisé dans le traitement de la constipation sévère.…”

Section: Traitementsunclassified

Quoi de neuf sur les troubles fonctionnels intestinaux depuis la fin du dernier millénaire ?

Coffin

2015

Colon Rectum

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Les troubles fonctionnels intestinaux (TFI) sont fré-quents et responsables de coûts directs et indirects importants. Durant la dernière décennie, de nombreuses avancées physiopathologiques ont été réalisées. En particulier le rôle d'une micro-inflammation, ainsi que la fonction et les dysfonctions du microbiote ont été mis en avant. Cependant, ces avancées n'ont pas permis d'isoler un ou plusieurs biomarqueurs qui permettraient un diagnostic biologique des TFI.Sur le plan thérapeutique, la première partie de la décennie a été marquée par l'échec de nouvelles molécules, liées à des effets secondaires graves. De nouvelles molécules sont en train d'apparaître. Le rôle des régimes, comme le régime sans gluten ou le régime pauvre en FODMAPs, se précise. Mots clés Troubles fonctionnels intestinaux · Inflammation · Microbiote · Dysbiose · TraitementAbstract IBS is frequent and induces important direct and indirect costs. During the last decade, several pathophysiological progresses have been reported. Particularly, the role La situation en l'an 2000

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Effect of linaclotide in irritable bowel syndrome with constipation (IBS‐C): a systematic review and meta‐analysis

Abstract: Linaclotide is moderately effective in improving symptoms of IBS-C with diarrhea being the major side effect. Further studies are needed to evaluate the long-term efficacy and safety of linaclotide for IBS-C.

Cited by 61 publications

References 29 publications

Analysis of Nausea in Clinical Studies of Lubiprostone for the Treatment of Constipation Disorders

Analysis of Nausea in Clinical Studies of Lubiprostone for the Treatment of Constipation Disorders

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult

Quoi de neuf sur les troubles fonctionnels intestinaux depuis la fin du dernier millénaire ?

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