Emerging pharmacologic therapies for irritable bowel syndrome

Noriaki Manabe, Archana S. Rao, Banny S. Wong, Michael Camilleri

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

New therapies are being developed for irritable bowel syndrome (IBS). These advances are based on understanding pathophysiology or the development of medications with greater selectivity in classes of agents with known efficacy. Prucalopride, the newest European Medicines Agency-approved 5-hydroxytryptamine receptor 4 (5-HT4) agonist, is effective in the treatment of chronic constipation with improved cardiovascular safety relative to older 5-HT 4 drugs; similarly, ramosetron, the 5-hydroxytryptamine receptor 3 (5-HT3) antagonist, appears efficacious in diarrhea-predominant IBS. Secretagogues with different mechanisms of action target apical domains in enterocytes that are involved in chloride secretion, such as chloride channels, the cystic fibrosis transmembrane regulator, and guanylate cyclase C. As a class, such secretagogues have high efficacy and safety for constipation. With more data obtained from phase 2 and 3 trials, we expect other classes of medications, including bile acid modulators, anti-inflammatory agents, visceral analgesics, and newer centrally acting agents to be efficacious and enter the armamentarium for the treatment of IBS in the future.

Original languageEnglish (US)
Pages (from-to)408-416
Number of pages9
JournalCurrent Gastroenterology Reports
Volume12
Issue number5
DOIs
StatePublished - Oct 2010

Fingerprint

Irritable Bowel Syndrome
prucalopride
Constipation
Receptors, Serotonin, 5-HT4
Safety
Receptors, Serotonin, 5-HT3
Chloride Channels
Enterocytes
Guanylate Cyclase
Bile Acids and Salts
Cystic Fibrosis
Analgesics
Chlorides
Diarrhea
Serotonin
Anti-Inflammatory Agents
Therapeutics
Pharmaceutical Preparations

Keywords

  • 5-HT antagonist
  • 5-HT agonist
  • Anti-inflammatory
  • Benzodiazepine receptor modulator
  • Bile acid
  • Constipation
  • Diarrhea
  • Peripheral visceral analgesic
  • Secretagogue
  • Treatment

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Emerging pharmacologic therapies for irritable bowel syndrome. / Manabe, Noriaki; Rao, Archana S.; Wong, Banny S.; Camilleri, Michael.

In: Current Gastroenterology Reports, Vol. 12, No. 5, 10.2010, p. 408-416.

Research output: Contribution to journalArticle

Manabe, Noriaki ; Rao, Archana S. ; Wong, Banny S. ; Camilleri, Michael. / Emerging pharmacologic therapies for irritable bowel syndrome. In: Current Gastroenterology Reports. 2010 ; Vol. 12, No. 5. pp. 408-416.
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