Systematic review: The efficacy of treatments for irritable bowel syndrome - A European perspective

J. Tack, M. Fried, L. A. Houghton, J. Spicak, G. Fisher

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

Background: Irritable bowel syndrome (IBS) is a common, chronic disorder, characterized by abdominal pain/discomfort, bloating and altered bowel habit. Aim: To conduct a systematic evidence-based review of pharmacological therapies currently used, or in clinical development, for the treatment of IBS in Europe. The safety and tolerability of these therapies are the subject of an accompanying review. Methods: A literature search was completed for randomized controlled studies which included adult patients with IBS and an active or placebo control, assessed IBS symptoms, and were published in English between January 1980 and June 2005. The level of evidence for efficacy was graded according to the quality of the trial design and the study outcome. Results: There is some evidence for improvement of individual IBS symptoms with antidiarrhoeals (diarrhoea), antispasmodics (abdominal pain/discomfort), bulking agents (constipation), tricyclic antidepressants (abdominal pain/ discomfort) and behavioural therapy. In contrast, there is strong evidence for the improvement of global IBS symptoms with two new serotonergic agents: the 5-HT4 selective agonist tegaserod (IBS with constipation) and the 5-HT3 antagonist alosetron (IBS with diarrhoea). Further data are required for the 5-HT3 antagonist, cilansetron, and the mixed 5-HT3antagonist/5-HT4 agonist renzapride before their utility in IBS can be appraised. Conclusions: There is limited evidence for the efficacy, safety and tolerability of therapies currently available in Europe for the treatment of IBS. Overall, there is an absence of pharmacological agents licensed specifically for the treatment of IBS subtypes, and new agents are awaited in Europe that will allow changes in clinical practice to focus on and improve global IBS symptoms.

Original languageEnglish (US)
Pages (from-to)183-205
Number of pages23
JournalAlimentary Pharmacology and Therapeutics
Volume24
Issue number2
DOIs
StatePublished - Jul 2006
Externally publishedYes

Fingerprint

Irritable Bowel Syndrome
Serotonin 5-HT4 Receptor Agonists
Abdominal Pain
Serotonin 5-HT3 Receptor Antagonists
Constipation
Therapeutics
Diarrhea
Pharmacology
Antidiarrheals
Serotonin Agents
Safety
Parasympatholytics
Tricyclic Antidepressive Agents
Habits
Placebos
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Systematic review : The efficacy of treatments for irritable bowel syndrome - A European perspective. / Tack, J.; Fried, M.; Houghton, L. A.; Spicak, J.; Fisher, G.

In: Alimentary Pharmacology and Therapeutics, Vol. 24, No. 2, 07.2006, p. 183-205.

Research output: Contribution to journalArticle

Tack, J. ; Fried, M. ; Houghton, L. A. ; Spicak, J. ; Fisher, G. / Systematic review : The efficacy of treatments for irritable bowel syndrome - A European perspective. In: Alimentary Pharmacology and Therapeutics. 2006 ; Vol. 24, No. 2. pp. 183-205.
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