Pinaverium Reduces Symptoms of Irritable Bowel Syndrome in a Multicenter, Randomized, Controlled Trial

Zheng, Liang; Lai, Yaoliang; Liu, Weimin; Li, Baiwen; Fan, Huiying; Yan, Zhixiang; Gong, Changzhen; Wan, Xinjian; Wu, Jing; Huang, Dawei; Wang, Yuanyuan; Mei, Yumei; Li, Zhen; Jiang, Zhengyan; Liu, Xingxing; Ye, Jingyi; Yang, Yongqiang; Huang, Huisuo; Xiao, Jun

doi:10.1016/j.cgh.2015.01.015

Cited by 64 publications

(64 citation statements)

References 13 publications

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“…We therefore included 26 RCTs (60, 63, 64, 149-171), evaluating 2811 patients with IBS. Risk of bias was low in two of the trials (149,150). Antispasmodic therapy had a statistically significant effect in improving IBS symptoms (RR of IBS symptoms not improving = 0.65; 95% CI 0.56 to 0.76).…”

Section: Quality Of Evidence: Very Lowmentioning

confidence: 94%

“…We identified three additional studies evaluating antispasmodics since the previous monograph (149)(150)(151). We therefore included 26 RCTs (60, 63, 64, 149-171), evaluating 2811 patients with IBS.…”

Section: Quality Of Evidence: Very Lowmentioning

confidence: 99%

“…Otilonium was studied in five RCTs, including 791 patients (162,163,168,169,171), with a beneficial effect (RR = 0.70; 95% CI 0.54 to 0.90), and a NNT of 5 (95% CI 4 to 11), but borderline heterogeneity between study results (I 2 = 44%, P = 0.13). Pinaverium bromide was studied in four trials (150,(156)(157)(158), assessing 615 patients, and there was a statistically significant effect on improving IBS symptoms (RR = 0.56; 95% CI 0.38 to 0.82) with a NNT of 4 (95% CI 3 to 6). There was statistically significant heterogeneity (I 2 = 61%, P = 0.05).…”

Section: Quality Of Evidence: Very Lowmentioning

confidence: 99%

See 2 more Smart Citations

American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome

Ford

Martin

Chey

et al. 2018

American Journal of Gastroenterology

276

396

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IntroductionIrritable bowel syndrome (IBS) is the most prevalent of the functional gastrointestinal disorders (FGIDs). Current estimates are that IBS affects up to 10-12% of adults in North America (1,2). Although it can affect all individuals regardless of age, creed, or gender, IBS is more common among women and is most commonly diagnosed in younger individuals (< age 50) (2, 3). IBS is characterized by recurrent abdominal pain and altered bowel habits; bloating and distention frequently coexist. The diagnosis of IBS is made by taking a careful history, eliciting key symptoms, as well as performing a physical examination and limited diagnostic testing (4-6). IBS is categorized into four main subtypes based on the predominant bowel habit: IBS with constipation (IBC-C); IBS with diarrhea (IBS-D); IBS with mixed symptomology (IBS-M); and unclassified IBS (5).IBS imposes a significant burden to the health care system and to individuals.Direct medical costs attributed to IBS in the US, excluding prescription and over-thecounter medicines, were estimated at $1.5-$10 billion per year in 2005 (7). Patients with IBS enrolled in a large Health Maintenance Organization (HMO) had significantly more outpatient visits and incurred nearly 50% more in total costs than individuals without IBS (8). A retrospective case-control study from another large HMO reported that patients with IBS had significantly more diagnostic tests, imaging, and surgery compared with patients without a diagnosis of IBS (9). Significant variations in care across the United States related to the diagnosis and treatment of IBS also play a role in excessive health care costs (10). The burden of IBS on individuals can be measured in a number of ways. Studies have demonstrated consistently that IBS impairs work-related activities (e.g., lost work time, reduced productivity while at work) and also reduces quality of life (11,12). The development Ford et al.Page 3 of 91 of effective and efficient treatment strategies for IBS assumes considerable importance, therefore, not just for the individual sufferer, but for society at large.Given the clinical heterogeneity that is a hallmark of the disorder and the absence of a single effective therapy for all sufferers, available therapies tend to focus on predominant symptomatology at presentation (i.e., altered bowel habits, abdominal pain, or bloating) (4-6). Based on their purported mode of action, many pharmacological therapies for IBS developed in recent decades have been directed towards those with a particular bowel habit, whether diarrhea or constipation.However, treating IBS patients can be difficult as no validated treatment algorithm exists, not all patients respond to treatment, and patients with similar symptoms frequently respond to the same treatment differently. Fortunately, a variety of novel therapeutic strategies are being explored and new compounds have appeared since the last iteration of the ACG monograph on IBS (4). The goal of this document, therefore, is to provide an updated, evidence-based d...

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Section: Quality Of Evidence: Very Lowmentioning

confidence: 94%

Section: Quality Of Evidence: Very Lowmentioning

confidence: 99%

Section: Quality Of Evidence: Very Lowmentioning

confidence: 99%

See 1 more Smart Citation

American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome

Ford

Martin

Chey

et al. 2018

American Journal of Gastroenterology

276

396

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“…Therefore, pinaverium bromide acts mainly on the gastrointestinal tract with high selectivity and has no adverse cardiovascular effects. [10]…”

Section: Discussionmentioning

confidence: 99%

Improvement of Quality of Nonanesthetic Colonoscopy by Preoperative Administration of Pinaverium Bromide

Wang

Zhou

Ren³

et al. 2017

Chinese Medical Journal

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Background:Nonanesthetic colonoscopy is popular in clinical practice in China. However, intestinal spasms often result in a prolonged examination time, increased operating difficulties, decreased polyp detection rate, and failure to complete the procedure clinically. Therefore, exploring alternative approaches that can reduce the pain in patients during colonoscopy is of utmost importance, and finding the optimal preoperative administration to improve the quality of nonanesthetic colonoscopy is also necessary. This study aimed to investigate the effects of the prophylactic administration of pinaverium bromide before colonoscopy and the effects of pinaverium bromide alone at different time points or combined with scopolamine butylbromide.Methods:A randomized controlled trial was performed on a cohort of 1000 patients who underwent colonoscopy in outpatient clinic of Wuhan Union Hospital. The patients were randomly assigned to the following groups: Group A, given oral pinaverium bromide (100 mg, three times a day) one day before examination combined with intramuscular injection of scopolamine butylbromide (20 mg) 10 min before colonoscopy; Group B0, given pinaverium bromide alone on the day of colonoscopy (100 mg, three times a day); Group B1, given pinaverium bromide alone (100 mg, three times a day) one day before colonoscopy; Group B2, given pinaverium bromide alone (100 mg, three times a day) two days before colonoscopy; and Group C, given scopolamine butylbromide alone (20 mg) before colonoscopy. The successful rate of colonoscopy, procedure time, degree of abdominal pain, and polyp detection rate were recorded and compared among all groups.Results:The successful rate of colonoscopy in Group B1 (82.0%) and Group B2 (83.0%) was significantly higher than that in Group B0 (62.0%, all P < 0.01). The time to reach the ileocecal region in Group B1 and Group B2 were lower than those in Group B0 (all P < 0.05). However, no significant differences were observed in polyp detection rate between Group B1 (24.0%) or Group B2 (26.0%), and Group B0 (22.4%, all P > 0.05). Furthermore, there were no significant differences in the various parameters examined between Group B1 and Group B2 (P > 0.05). The successful rate of colonoscopy in Group A (92.0%) was significantly higher than that in Group B1 (82.0%) and Group C (80.0%; both P < 0.05). Moreover, the time for the colonoscope to reach the ileocecal region in Group A were markedly shorter as compared to those in Group B1 and Group C (P < 0.05). The polyp detection rate in Group A was 32.0%, significantly higher than that in Group B1 (24.0%, P < 0.05) and Group C (24.2%, P < 0.05).Conclusion:Administration of pinaverium bromide alone one day before examination was beneficial to relieve symptoms of abdominal pain during nonanesthetic colonoscopy. In addition, therapeutic effects were improved when pinaverium bromide administration was combined with intramuscular injection of scopolamine butylbromide. Therefore, the combined use of pinaverium bromide with scopolamine butylbromi...

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“…1 The authors reported that over 75% of patients receiving pinaverium had either a 30% reduction from baseline in abdominal pain or a 50% reduction in the number of days with at least one stool with a Bristol stool score ≥6 at week 4, compared with 33.5% with placebo (P < 0.001).…”

Section: Word Count: 417mentioning

confidence: 99%

Pinaverium in Irritable Bowel Syndrome: Old Drug, New Tricks?

Davies

Ford

2015

Clinical Gastroenterology and Hepatology

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Pinaverium Reduces Symptoms of Irritable Bowel Syndrome in a Multicenter, Randomized, Controlled Trial

Cited by 64 publications

References 13 publications

American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome

American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome

Improvement of Quality of Nonanesthetic Colonoscopy by Preoperative Administration of Pinaverium Bromide

Pinaverium in Irritable Bowel Syndrome: Old Drug, New Tricks?

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