Systematic review with meta-analysis: lubiprostone efficacy on the treatment of patients with constipation

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Main idea: Current findings demonstrated that lubiprostone is beneficial in terms of SBM frequency for CIC, IBS-C, and OIC. In terms of abdominal symptoms, the most pronounced effect was seen for abdominal pain in IBS-C patients.

Abstract

Lubiprostone is a type 2 chloride channel activator that has been shown to be efficacious and safe in the treatment of chronic constipation.

The main goal of the study was to systematically review randomized clinical trials (RCTs) assessing the efficacy of lubiprostone in patients with chronic idiopathic constipation (CIC), irritable bowel syndrome with predominant constipation (IBS-C), and opioid-induced constipation (OIC).

Searches yielded 109 records representing 93 non-duplicate publications, and 11 RCTs (978 CIC, 1,366 IBS-C, 1,300 OIC, total = 3,644) met inclusion criteria. Qualitative synthesis showed that for CIC patients, lubiprostone is superior to placebo in terms of SBM outcomes. Meta-analysis for CIC was feasible for full responder and SBM within 24h rates, indicating superiority of lubiprostone over placebo. For IBS-C, lubiprostone was significantly superior to all SBM outcomes in follow-ups ranging from 1 week to 3 months. In terms of abdominal pain, lubiprostone provided significantly better symptoms’ relief, particularly after 1 month of treatment. For OIC, lubiprostone was more effective than placebo for both SBM and discomfort measures.

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