ABSTRACT
Tegaserod is a drug in a new class of compounds called aminoguanidine indoles and is structurally similar to serotonin (5-HT) with modifications that make the drug selective for the 5-HT(4) receptor. Tegaserod has a stimulatory effect on gastrointestinal (GI) motility that has been demonstrated in animal studies and in healthy adults. Tegaserod also increases GI secretion and reduces rectal sensitivity. Tegaserod is currently approved by the FDA for the treatment of women with constipation-predominant irritable bowel syndrome (C-IBS). Eight large Phase III clinical trials involving > 5000 IBS patients support the clinical efficacy of tegaserod in this group of patients. Patients who were treated with tegaserod had an overall improvement in IBS symptoms (Subject's Assessment of Global Relief) as well as in secondary end points, such as abdominal pain and discomfort, stool consistency, change in bowel movements and relief of bloating. Tegaserod was well-tolerated. The most common adverse reaction in clinical trials was diarrhoea, which was usually temporary and mild, although severe diarrhoea requiring hospitalisation has been rarely (< 1%) reported.
Subject(s)
Gastrointestinal Agents/therapeutic use , Indoles/therapeutic use , Irritable Bowel Syndrome/drug therapy , Serotonin Receptor Agonists/therapeutic use , Animals , Clinical Trials, Phase III as Topic , Female , Gastrointestinal Agents/adverse effects , Gastrointestinal Agents/pharmacokinetics , Humans , Indoles/adverse effects , Indoles/pharmacokinetics , Male , Serotonin Receptor Agonists/adverse effects , Serotonin Receptor Agonists/pharmacokineticsABSTRACT
Irritable bowel syndrome (IBS) is a common disorder with a worldwide distribution; it is characterized by abdominal pain and discomfort associated with an alteration of bowel function. The treatment approach for IBS depends on the patient's presenting symptoms at the time of diagnosis, and treatment is usually directed toward the predominant symptom. In this review we discuss the current approach to the treatment of IBS.
Subject(s)
Colonic Diseases, Functional/therapy , Practice Patterns, Physicians'/trends , Colonic Diseases, Functional/diagnosis , Colonic Diseases, Functional/physiopathology , HumansABSTRACT
Irritable bowel syndrome (IBS) is characterised by abnormalities in motility, sensation and perception. It is one of the most common conditions encountered in clinical practice, especially by gastroenterologists. Pharmacological treatment of IBS is aimed at the predominant symptom and recent advances in pathophysiology has opened the door to the development of new compounds that target specific receptors. During this review, the most promising investigational and recently approved drugs will be discussed.
