Emerging pharmacologic therapies for irritable bowel syndrome

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

Research output: Contribution to journalReview article

16 Scopus citations

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 1 2010

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

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