The Efficacy of Lubiprostone in Patients of Constipation: An Updated Systematic Review and Meta-Analysis

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-01-15 DOI:10.1002/jgh3.70070

Umar Akram, Obaid Ur Rehman, Eeshal Fatima, Zain Ali Nadeem, Omer Usman, Waqas Rasheed, Ramsha Ali, Khawaja Abdul Rehman, Abdulqadir J. Nashwan

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Abstract

Background and Aim

Lubiprostone increases chloride and water secretion in the intestines, and several studies have demonstrated the efficacy of lubiprostone in treating functional constipation. Several new clinical trials have emerged since the previous meta-analysis conducted in 2020. We conducted this updated meta-analysis to assess clinical efficacy of lubiprostone in these patients.

Methods

A systematic search was conducted on MEDLINE, Cochrane, and Scopus. Randomized controlled trials published between July 2019 and June 2024 were selected. Cochrane's RoB 2 tool was used to assess the risk of bias. A meta-analysis was performed and findings were presented using forest plots.

Results

A total of 14 studies, comprising 4550 patients, were included in the review. Only 12 studies were pooled in the meta-analysis. Lubiprostone was associated with greater spontaneous bowel movements (SBM) per week (RR 1.454, 95% CI 1.193–1.771) and SBM within 24 h (RR 1.790, 95% CI 1.491–2.150) in patients with chronic idiopathic constipation (CIC). However, it was not associated with abdominal pain in either arm (RR 1.415, 95% CI 0.873–2.294). In opioid-induced constipation (OIC), lubiprostone increased SBM within 24 h (RR 1.277, 95% CI 1.105–1.475) but did not significantly affect abdominal pain (RR 4.321, 95% CI 0.624–29.941). Lubiprostone improved all selected SBM-related and abdominal pain outcomes in patients with irritable bowel syndrome with constipation (IBS-C).

Conclusion

Lubiprostone significantly improves all SBM-related outcomes. Owing to its good safety and efficacy profile, lubiprostone can be used in the combination regimens for management of CIC, IBS-C, and OIC.

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Lubiprostone在便秘患者中的疗效：一项最新的系统综述和荟萃分析。

背景与目的：Lubiprostone可增加肠内氯离子和水分的分泌，多项研究证实Lubiprostone治疗功能性便秘的疗效。自2020年进行的上一次荟萃分析以来，出现了几项新的临床试验。我们进行了这项最新的荟萃分析，以评估鲁比前列酮在这些患者中的临床疗效。方法：在MEDLINE、Cochrane和Scopus上进行系统检索。选择2019年7月至2024年6月发表的随机对照试验。采用Cochrane的RoB 2工具评估偏倚风险。进行了荟萃分析，并使用森林样地呈现了研究结果。结果：共纳入14项研究，包括4550例患者。荟萃分析中只有12项研究。Lubiprostone与慢性特发性便秘（CIC）患者每周更多的自发排便（SBM）（RR 1.454, 95% CI 1.193-1.771）和24小时内更多的自发排便（RR 1.790, 95% CI 1.491-2.150）相关。然而，它与两臂的腹痛无关（RR 1.415, 95% CI 0.873-2.294）。在阿片类药物引起的便秘（OIC）中，脂比prostone在24 h内增加了SBM (RR 1.277, 95% CI 1.105-1.475)，但对腹痛没有显著影响（RR 4.321, 95% CI 0.624-29.941）。Lubiprostone改善了肠易激综合征合并便秘（IBS-C）患者所有选择的sbm相关和腹痛结局。结论：Lubiprostone可显著改善sbm相关的所有预后。由于其良好的安全性和有效性，lubiprostone可用于治疗CIC， IBS-C和OIC的联合方案。

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