Placebo-controlled trial of lubiprostone for constipation associated with Parkinson disease

Ondo, William G.; Kenney, C.; Sullivan, Kelly L.; Davidson, Anthony; Hunter, Christine; Jahan, Israt; McCombs, A.; Miller, Austinn C.; Zesiewicz, Theresa

doi:10.1212/wnl.0b013e3182574f28

Cited by 91 publications

(52 citation statements)

References 31 publications

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“…Moreover, stool softeners such as docusate sodium may be used alone or in combination with psyllium husks to increase stool volume and, therefore, peristalsis reflex [6, 7, 125]. By increasing intestinal fluid secretion, lubiprostone, an intestinal ClC-2 chloride channel activator, also improves constipation issues (64% of PD patients) [7, 28, 52, 126]. The most common adverse events observed were intermittent loose stools (48% of PD patients), nausea (29%), diarrhea (12%), abdominal pain (8%), flatulence (6%), dizziness (3%), and vomiting (3%) [52, 126, 127].…”

Section: Therapeutic Approaches To Gi Symptomsmentioning

confidence: 99%

“…By increasing intestinal fluid secretion, lubiprostone, an intestinal ClC-2 chloride channel activator, also improves constipation issues (64% of PD patients) [7, 28, 52, 126]. The most common adverse events observed were intermittent loose stools (48% of PD patients), nausea (29%), diarrhea (12%), abdominal pain (8%), flatulence (6%), dizziness (3%), and vomiting (3%) [52, 126, 127]. Methylnaltrexone ( µ -opioid antagonist) is another medicinal agent approved in the USA and indicated for the treatment of opioid-induced constipation, with approximately 60% of patients having reported beneficial intestinal effects [28, 128].…”

Section: Therapeutic Approaches To Gi Symptomsmentioning

confidence: 99%

See 1 more Smart Citation

Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments

Poirier

Aubé

Côté

et al. 2016

Parkinson's Disease

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A diagnosis of Parkinson's disease is classically established after the manifestation of motor symptoms such as rigidity, bradykinesia, and tremor. However, a growing body of evidence supports the hypothesis that nonmotor symptoms, especially gastrointestinal dysfunctions, could be considered as early biomarkers since they are ubiquitously found among confirmed patients and occur much earlier than their motor manifestations. According to Braak's hypothesis, the disease is postulated to originate in the intestine and then spread to the brain via the vagus nerve, a phenomenon that would involve other neuronal types than the well-established dopaminergic population. It has therefore been proposed that peripheral nondopaminergic impairments might precede the alteration of dopaminergic neurons in the central nervous system and, ultimately, the emergence of motor symptoms. Considering the growing interest in the gut-brain axis in Parkinson's disease, this review aims at providing a comprehensive picture of the multiple gastrointestinal features of the disease, along with the therapeutic approaches used to reduce their burden. Moreover, we highlight the importance of gastrointestinal symptoms with respect to the patients' responses towards medical treatments and discuss the various possible adverse interactions that can potentially occur, which are still poorly understood.

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Section: Therapeutic Approaches To Gi Symptomsmentioning

confidence: 99%

Section: Therapeutic Approaches To Gi Symptomsmentioning

confidence: 99%

Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments

Poirier

Aubé

Côté

et al. 2016

Parkinson's Disease

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show abstract

“…[45] One randomized controlled trial manifested that lubiprostone seemed to be well tolerated and effective for the short-term treatment of constipation in PD. [46] Cassani et al . in their investigation showed that a regular intake of probiotics can significantly improve stool consistency and bowel habits in PD patients.…”

Section: Parkinson's Diseasementioning

confidence: 99%

Gastrointestinal dysfunction in idiopathic Parkinsonism: A narrative review

2016

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Currently, gastrointestinal (GI) dysfunctions in Parkinson's disease (PD) are well-recognized problems and are known to be the initial symptoms in the pathological process that eventually results in PD. Many types of PD-associated GI dysfunctions have been identified, including weight loss, nausea, hypersalivation, dysphagia, dyspepsia, abdominal pain, intestinal pseudo-obstruction, constipation, defecatory dysfunction, and small intestinal bacterial overgrowth. These symptoms can influence on other PD symptoms and are the second most significant predictor of the quality of life of these patients. Recognition of GI symptoms requires vigilance on the part of clinicians. Health-care providers should routinely ask direct questions about GI symptoms during office visits so that efforts can be directed at appropriate management of these distressing manifestations. Multiple system atrophy (MSA) and progressive supranuclear palsy are two forms of neurodegenerative Parkinsonism. Symptoms of autonomic dysfunctions such as GI dysfunction are common in patients with parkinsonian disorders. Despite recent progress in the recognition of GI dysfunctions, there are a few reviews on the management of GI dysfunction and GI symptoms in idiopathic Parkinsonism. In this review, the clinical presentation, pathophysiology, and treatment of each GI symptom in PD, MSA, and prostate-specific antigen will be discussed.

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“…Lubiprostone was just recently approved in 2012 for the treatment of chronic constipation in Japan. Although its safety and efficacy in elderly patients still require further research (36), this drug has shown efficacy in small studies of constipation due to Parkinson's disease or opioid use (37,38), two situations that are frequently encountered in elderly populations. The most common adverse effects are diarrhea and nausea (39).…”

Section: Discussionmentioning

confidence: 99%

Obstructive Uropathy Caused by Chronic Constipation

2015

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We herein report a case regarding a 90-year-old woman with a history of recurrent episodes of urinary tract infections presenting with fever. Urinalysis revealed bacteria and white blood cells. Computed tomography showed dilated and fecally loaded rectum and colon with signs of obstructive uropathy. The patient was treated for urinary tract infection and constipation. Her bowel habits were controlled with lubiprostone, and she was discharged in good medical condition. This case highlights the importance of considering fecal impaction as a cause of urinary tract obstruction or infection.

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Placebo-controlled trial of lubiprostone for constipation associated with Parkinson disease

Abstract: In this randomized controlled trial, lubiprostone seemed to be well tolerated and effective for the short-term treatment of constipation in PD.

Cited by 91 publications

References 31 publications

Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments

Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments

Gastrointestinal dysfunction in idiopathic Parkinsonism: A narrative review

Obstructive Uropathy Caused by Chronic Constipation

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