4种已获批药物均可有效缓解便秘型IBS患者的腹胀
创作:this little piggy 审核:aluba 06月25日
  • 纳入13项随机对照试验(共包含10091名IBS-C患者)进行荟萃分析,总结4种已获得FDA批准的IBS-C治疗药物的疗效;
  • 这些药物包括:鲁比前列酮(前列腺素E1衍生物)、利那洛肽(鸟苷酸环化酶-C受体激动剂)、特纳帕诺(钠氢交换蛋白3抑制剂)、替加色罗(5-羟色胺4受体激动剂);
  • 利那洛肽、鲁比前列酮、特纳帕诺及替加色罗治疗腹胀的疗效均显著优于安慰剂;
  • 间接比较显示各药物间无显著差异,而利那洛肽似乎对缓解腹胀最有效。
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aluba
腹胀是便秘型肠易激综合征(IBS-C)患者中的常见症状。Alimentary Pharmacology and Therapeutics上发表的一项荟萃分析结果,总结了13项随机对照试验(纳入超过1万名IBS-C患者)的数据后发现,4种已获FDA批准的IBS-C治疗药物(鲁比前列酮、利那洛肽、特纳帕诺及替加色罗)均可有效缓解患者的腹胀,其中利那洛肽的效果最好。
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Systematic review and network meta-analysis: efficacy of licensed drugs for abdominal bloating in irritable bowel syndrome with constipation

系统性综述与网络荟萃分析:已获批药物治疗便秘型IBS患者的腹胀的疗效

10.1111/apt.16437

06-11, Article

Abstract & Authors:展开

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BACKGROUND: Although bloating is a highly prevalent and troublesome symptom in irritable bowel syndrome with constipation (IBS-C), treatment is empirical with no specific guidelines for its management.
AIM: To conduct a pairwise and network meta-analysis, using a frequentist approach, of Food and Drug Administration-licensed drugs for IBS-C comparing their efficacy for abdominal bloating as a specific endpoint.
METHODS: We searched the medical literature through December 2020 to identify randomised controlled trials (RCTs) in IBS-C, with abdominal bloating reported as a dichotomous assessment. Efficacy of each drug was reported as a pooled relative risk (RR) with 95% confidence intervals (CIs) to summarise effect of each comparison tested. Treatments were ranked according to their P-score.
RESULTS: We identified 13 eligible RCTs, containing 10 091 patients. Linaclotide 290 µg o.d., lubiprostone 8 µg b.d., tenapanor 50 mg b.d. and tegaserod 6 mg b.d. were all superior to placebo for abdominal bloating in patients with IBS-C, in both pairwise and the network meta-analyses. Linaclotide demonstrated the greatest improvement in abdominal bloating in both pairwise and network meta-analysis (RR of failure to achieve an improvement in abdominal bloating = 0.78; 95% CI 0.74-0.83, number needed to treat = 7, P-score 0.97). Indirect comparison revealed no significant differences between individual drugs.
CONCLUSIONS: We found all licensed drugs for IBS-C to be superior to placebo for abdominal bloating. Linaclotide appeared to be the most efficacious at relieving abdominal bloating. Further research is needed to assess long-term efficacy of these agents and to better understand the precise mechanism of improving bloating.

First Authors:
Alfred D Nelson

Correspondence Authors:
Brian E Lacy,Alexander C Ford

All Authors:
Alfred D Nelson,Christopher J Black,Lesley A Houghton,Nahyr Sofía Lugo-Fagundo,Brian E Lacy,Alexander C Ford

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