Lubiprostone Is Effective in the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome

Fan, Li; Fu, Tao; Tong, Weidong; Liu, Baohua; Li, Chunxue; Gao, Yu; Wu, Jinsong; Wang, Xiangfeng; Zhang, Anping

doi:10.1016/j.mayocp.2016.01.015

Cited by 59 publications

(45 citation statements)

References 29 publications

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“…These results were generally replicated in a systematic review and meta-analysis,90 which showed the 3 months combined standardised difference in mean change of 0.181 (95% CI 0.212 to 0.573; p=0.37).…”

Section: Current Approaches To Manage Visceral Pain In Patients With Ibsmentioning

confidence: 68%

Dietary and pharmacological treatment of abdominal pain in IBS

Camilleri

Boeckxstaens

2017

Gut

121

122

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This review introduces the principles of visceral sensation and appraises the current approaches to management of visceral pain in functional GI diseases, principally IBS. These approaches include dietary measures including fibre supplementation, low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet, and pharmacological approaches such as antispasmodics, peppermint oil, antidepressants (tricyclic agents, selective serotonin reuptake inhibitors), 5-HT receptor antagonists (alosetron, ondansetron, ramosetron), non-absorbed antibiotic (rifaximin), secretagogues (lubiprostone, linaclotide), μ-opioid receptor (OR) and κ-OR agonist, δ-OR antagonist (eluxadoline), histamine H1 receptor antagonist (ebastine), neurokinin-2 receptor antagonist (ibodutant) and GABAergic agents (gabapentin and pregabalin). Efficacy and safety are discussed based on pivotal trials or published systematic reviews and meta-analysis, expressing ORs or relative risks and their 95% CIs. Potential new approaches may be based on recent insights on mucosal expression of genes, and microRNA and epigenetic markers in human biopsies and in animal models of visceral hypersensitivity.The objectives of this review are to appraise the physiology and anatomy of gut sensation and the efficacy in the relief of visceral pain (typically in IBS) of several classes of therapies. These include fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and different classes of medications (box 1). Box 1Classes of pharmacological agents for visceral painAntidepressants (tricyclic agents, selective serotonin reuptake inhibitors)Peppermint oil5-HT receptor antagonists (alosetron, ondansetron, ramosetron)Non-absorbed antibiotic (rifaximin)Secretagogues (lubiprostone, linaclotide)μ-Opioid receptor (OR) and κ-OR agonist and δ-OR antagonist (eluxadoline)Histamine H1 receptor antagonist (ebastine)Neurokinin-2 receptor antagonist (ibodutant)GABAergic agents (gabapentin and pregabalin).

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Section: Current Approaches To Manage Visceral Pain In Patients With Ibsmentioning

confidence: 68%

Dietary and pharmacological treatment of abdominal pain in IBS

Camilleri

Boeckxstaens

2017

Gut

121

122

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“…Its mode of action involves induction of water and chloride secretion into the intestinal lumen, leading in turn to decreased stool consistency as well as increased stool volumes and stool transit velocity. Lubiprostone has been shown to be clearly more effective than placebo in several studies and meta-analyses [27], and has been associated with reports of possible adverse effects including diarrhea, nausea, and abdominal cramps. Peripherally Acting μ-Opioid Antagonists (PAMORA) for Opioid-Induced Constipation Opioids play a significant role in the management of chronic pain.…”

Section: Secretagoguesmentioning

confidence: 99%

Medical Therapy of Constipation: Current Standards and Beyond

Andresen

Layer²

2018

Visc Med

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Chronic constipation is a very common medical problem with relevant impact on the patients' quality of life. Modern definitions recognize constipation as a polysymptomatic disorder, including various aspects of disturbed defecation. Current guidelines recommend a stepwise approach in the management of chronic constipation. Isolated or concomitant evacuation disorders should be identified and may need differential/additional treatment. Baseline measures include lifestyle components and bulking agents. The next step recommends treatment with conventional laxatives. In refractory patients, modern medical therapies, such as the prokinetic prucalopride or the secretagogues linalotide or lubiprostone, may be used effectively. For patients with opioid-induced constipation, the modern concept of peripherally acting µ-opioid antagonists has shown to successfully improve this increasing medical problem and even to potentially increase survival time in terminally ill patients on opioid therapy. Prolonged-released oral naloxone (in fixed combination with oxycodone), oral naloxegol or naldemedine, and subcutaneous methylnaltrexone have all demonstrated good efficacy and tolerability in the treatment of opioid-induced constipation. To adequately apply stepwise treatment algorithms, a simple tool to identify treatment failure may improve patient care.

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“…Lubiprostone also promotes repair of epithelial barrier (Cuppoletti et al, 2012). Most recent metaanalysis by Li et al (2016) confirmed the effectiveness and safety of lubiprostone in diminishing the severity of constipation and improving stool consistency, degree of abdominal pain and discomfort. Compared to alternative therapies, patients on lubiprostone have improved health-related quality of life, symptom control, reduced symptoms severity and are more satisfied with their therapy (Solem et al, 2016).…”

Section: Pufas In Irritable Bowel Syndromementioning

confidence: 97%

“…Of note, lubiprostone, a PGE1 derivative, has been registered in the treatment of IBS-C and chronic idiopathic constipation (CIC). It activates type 2 chloride channels in apical membrane of intestinal epithelium and thus increases fluid secretion in the GI tract (Li et al, 2016). Lubiprostone also promotes repair of epithelial barrier (Cuppoletti et al, 2012).…”

Section: Pufas In Irritable Bowel Syndromementioning

confidence: 99%

Polyunsaturated Fatty Acids and Their Derivatives: Therapeutic Value for Inflammatory, Functional Gastrointestinal Disorders, and Colorectal Cancer

2016

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Polyunsaturated fatty acids (PUFAs) are bioactive lipids which modulate inflammation and immunity. They gained recognition in nutritional therapy and are recommended dietary supplements. There is a growing body of evidence suggesting the usefulness of PUFAs in active therapy of various gastrointestinal (GI) diseases. In this review we briefly cover the systematics of PUFAs and their metabolites, and elaborate on their possible use in inflammatory bowel disease (IBD), functional gastrointestinal disorders (FGIDs) with focus on irritable bowel syndrome (IBS), and colorectal cancer (CRC). Each section describes the latest findings from in vitro and in vivo studies, with reports of clinical interventions when available.

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Lubiprostone Is Effective in the Treatment of Chronic Idiopathic Constipation and Irritable Bowel Syndrome

Cited by 59 publications

References 29 publications

Dietary and pharmacological treatment of abdominal pain in IBS

Dietary and pharmacological treatment of abdominal pain in IBS

Medical Therapy of Constipation: Current Standards and Beyond

Polyunsaturated Fatty Acids and Their Derivatives: Therapeutic Value for Inflammatory, Functional Gastrointestinal Disorders, and Colorectal Cancer

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