Efficacy and Safety of Linaclotide in Irritable Bowel Syndrome With Constipation: A Meta-analysis / 胃肠病学

ABSTRACT

Background: Irritable bowel syndrome with constipation (IBS-C) is a common functional gastrointestinal disorder. The current commonly used therapeutic drugs are not quite effective. Linaclotide is the globally first guanylate cyclase-C agonist, and provides a new selection for the treatment of IBS-C. Aims: To systematically evaluate the efficacy and safety of linaclotide in treatment of patients with IBS-C. Methods: Randomized controlled trials (RCTs) of linaclotide in the treatment of IBS-C were retrieved from CNKI, Wanfang Database, China VIP Database, PubMed, Embase, Cochrane Library. Literatures were independently screened by three reviewers, data were extracted and quality of the included studies was evaluated. The meta-analysis of efficacy of linaclotide on abdominal pain, complete spontaneous bowel movements (CSBM), spontaneous bowel movements (SBM)≤ 24 hours after first dose, adequate relief of IBS-C symptoms, constipation severity, IBS severity, and incidence of adverse reactions were conducted. Results: A total of six RCTs meeting the requirements were retrieved. Linaclotide could improve abdominal pain (RR=1.49, 95% CI 1.15-1.92), CSBM (RR=3.03, 95% CI 2.41-3.82), SBM≤ 24 hours after first dose (RR=1.60, 95% CI 1.49-1.72), adequate relief of IBS-C symptoms (RR=1.63, 95% CI 1.27-2.10), constipation severity (RR=1.45, 95% CI 1.34-1.57), IBS severity (RR=1.44, 95% CI 1.32-1.57). The incidences of diarrhea and bloat were significantly increased in linaclotide group than in placebo group, however, tolerance of the adverse reactions was well. Conclusions: Linaclotide has good efficacy, safety and tolerance in the treatment of IBS-C, and is a comparatively ideal drug for treatment of IBS-C.