TY - JOUR
T1 - Comparative profiles of lubiprostone, linaclotide, and elobixibat for chronic constipation
T2 - a systematic literature review with meta-analysis and number needed to treat/harm
AU - Rao, Satish S.
AU - Manabe, Noriaki
AU - Karasawa, Yusuke
AU - Hasebe, Yuko
AU - Nozawa, Kazutaka
AU - Nakajima, Atsushi
AU - Fukudo, Shin
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2024/12
Y1 - 2024/12
N2 - Objective: To comprehensively evaluate the efficacy, safety, patient symptoms, and quality-of-life (QoL) of lubiprostone, linaclotide, and elobixibat as treatment for chronic constipation (CC). Design: Systematic literature review (SLR) and meta-analysis (MA). Literature searches were conducted on PubMed and Embase using the Ovid platform. Methods: SLR including randomized controlled trials (RCTs) and observational studies was conducted to identify the overall efficacy and safety of lubiprostone, linaclotide, and elobixibat. Thereafter, MA was performed using only RCTs. The number needed to treat (NNT) and number needed to harm (NNH) analyses were additionally conducted. Primary and secondary outcome measures: The primary outcome was efficacy regarding change in spontaneous bowel movements. Secondary outcomes included safety, constipation-related symptoms, and QoL. Results: Twenty-four studies met the inclusion criteria for the SLR: 17 RCTs, 4 observational studies, and 3 single-arm trials. Feasibility assessment for the MA resulted in 14 studies available for safety data analysis, and 8 available for efficacy analysis, respectively. Three drugs showed similar efficacy in the MA and NNT analysis. However, the NNH analysis revealed distinct safety profiles: lubiprostone, linaclotide, and elobixibat were linked to the highest risk of nausea, diarrhea, and abdominal pain, respectively. Conclusion: The current study provides an updated overview of the efficacy, safety, patient symptoms, and QoL of the three drugs with different mechanisms of action for CC treatment.The findings could help physicians adopt an individualized approach for treating patients with CC in clinical practice.
AB - Objective: To comprehensively evaluate the efficacy, safety, patient symptoms, and quality-of-life (QoL) of lubiprostone, linaclotide, and elobixibat as treatment for chronic constipation (CC). Design: Systematic literature review (SLR) and meta-analysis (MA). Literature searches were conducted on PubMed and Embase using the Ovid platform. Methods: SLR including randomized controlled trials (RCTs) and observational studies was conducted to identify the overall efficacy and safety of lubiprostone, linaclotide, and elobixibat. Thereafter, MA was performed using only RCTs. The number needed to treat (NNT) and number needed to harm (NNH) analyses were additionally conducted. Primary and secondary outcome measures: The primary outcome was efficacy regarding change in spontaneous bowel movements. Secondary outcomes included safety, constipation-related symptoms, and QoL. Results: Twenty-four studies met the inclusion criteria for the SLR: 17 RCTs, 4 observational studies, and 3 single-arm trials. Feasibility assessment for the MA resulted in 14 studies available for safety data analysis, and 8 available for efficacy analysis, respectively. Three drugs showed similar efficacy in the MA and NNT analysis. However, the NNH analysis revealed distinct safety profiles: lubiprostone, linaclotide, and elobixibat were linked to the highest risk of nausea, diarrhea, and abdominal pain, respectively. Conclusion: The current study provides an updated overview of the efficacy, safety, patient symptoms, and QoL of the three drugs with different mechanisms of action for CC treatment.The findings could help physicians adopt an individualized approach for treating patients with CC in clinical practice.
KW - Constipation
KW - Elobixibat
KW - Linaclotide
KW - Lubiprostone
KW - Meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85181255650&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85181255650&partnerID=8YFLogxK
U2 - 10.1186/s12876-023-03104-8
DO - 10.1186/s12876-023-03104-8
M3 - Article
C2 - 38166671
AN - SCOPUS:85181255650
SN - 1471-230X
VL - 24
JO - BMC Gastroenterology
JF - BMC Gastroenterology
IS - 1
M1 - 12
ER -