Elobixibat alleviates chronic constipation in hemodialysis patients: a questionnaire-based study

Abstract

Background: Hemodialysis patients are prone to constipation, which can adversely affect their quality of life (QOL). Elobixibat, a highly selective inhibitor of the ileal bile acid transporter, can increase the bile acid level in the colon and, subsequently, enhance colonic motility and secretion. In hemodialysis patients with chronic constipation, it may have a novel action mechanism. However, the effect of elobixibat on such patients' QOL had not been reported. This study aimed to evaluate the effect of elobixibat on the QOL of hemodialysis patients with chronic constipation.Methods: This was a multicenter, observational study that used the Japanese version of the Patient Assessment of Constipation-Quality of Life (PAC-QOL) questionnaire on 27 patients (18 men and nine women, age range 47-90 years), who satisfied the Rome 3 diagnostic criteria for functional constipation and were already taking other drugs for constipation. These patients were administered elobixibat 10 mg/day and were asked to respond to the PAC-QOL questionnaire at baseline and after 4 weeks. Bayesian statistics were used to confirm our results. Results: The number of spontaneous bowel movements per week increased significantly from 2.6 ± 1.2 to 4.1 ± 2.1 (p < 0.001), and the Bristol Stool Form Scale score significantly improved from 1.9 ± 0.8 to 3.6 ± 0.7 (p < 0.001). The Cronbach's alpha was 0.95, and the Guttman split-half reliability coefficient was 0.90. There were significant decreases in the physical discomfort scores from 1.94 ± 0.79 to 0.97 ± 0.72 (p < 0.001); psychosocial discomfort from 1.16 ± 0.93 to 0.63 ± 0.58 (p < 0.001); worries/ concerns from 1.84 ± 0.73 to 1.27 ± 0.59 (p < 0.001), and satisfaction from 2.79 ± 0.61 to 1.98 ± 0.77 (p < 0.001). The total PAC-QOL score significantly decreased from 1.83 ± 0.79 to 1.17 ± 0.56 (p < 0.001). Bayesian statistics confirmed the results' significance. Conclusions: Elobixibat reduced the PAC-QOL scores for hemodialysis patients with chronic constipation and improved the patients' QOL. It may serve as a new option for treating constipation in hemodialysis patients.

Constipation and the Quality of Life in Conservatively Treated Chronic Kidney Disease Patients: A Cross-sectional Study

“…Such studies could also determine whether the treatment of constipation significantly improves HRQoL in this population. In a multicenter, observational study of hemodialysis patients with FC, elobixibat significantly increased the frequency of BM and improved patients' HRQoL 55 . Furthermore, based on mechanistic insights into the “gut-kidney-heart” axis, Sumida and Kovesdy have recently hypothesized that the administration of laxatives might be a gut microbiota-targeted therapeutic intervention for reduction cardiovascular risk in patients with CKD 37 .…”

Effects of Elobixibat on Constipation and Lipid Metabolism in Patients With Moderate to End-Stage Chronic Kidney Disease

“…A recent phase III clinical study showed that elobixibat increased the frequency of spontaneous bowel movements in non-renal impaired patients with chronic constipation ( 9 ). An observational study reported that elobixibat increased the number of spontaneous bowel movements in patients with chronic constipation undergoing hemodialysis ( 13 ). In the present study, elobixibat increased stool frequency in patients with moderate to end-stage CKD, and its effect on improving constipation was similar between patients with CKD stages G3–G5 and G5D.…”

Real-World Comparison of Elobixibat and Lubiprostone Treatment in Patients with Chronic Constipation: A Propensity Score-Matched Analysis

“…However, the number of SBMs after elobixibat administration was approximately 4.2 times per week, which indicates a normal bowel movement. Kamei et al [39] reported that elobixibat is suitable for patients undergoing dialysis thrice a week to be adjusted to promote defecation within days other than dialysis days; they added that a moderate increase in SBMs may be beneficial. Considering the SCS results after administration, the SCS in the E10 group was significantly lower than that in the L24 and L48 groups.…”