Drug Survival of Drugs Recommended for Irritable Bowel Syndrome: A Retrospective Observational Study.

IF 2.9 3区医学 Q1 CLINICAL NEUROLOGY

Neurogastroenterology and Motility Pub Date : 2025-10-01 Epub Date: 2025-04-24 DOI:10.1111/nmo.70063

Alice Sandberg-Janzon, Pontus Karling

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引用次数: 0

Abstract

Background: There is limited data on how drugs prescribed for functional bowel disorders are re-prescribed in clinical practice. This study aimed to investigate drug survival rates of different irritable bowel syndrome (IBS) treatments among patients referred to a gastroenterologist.

Methods: A retrospective observational study was conducted by reviewing medical charts of patients aged 18-50 years, diagnosed with IBS or an unspecified functional intestinal disorder between 2010 and 2018. Drug survival rates for various treatment categories were analyzed using Kaplan-Meier curves and log-rank tests.

Results: A total of 1528 treatment attempts were recorded in 529 patients, with 883 classified as treatment-naïve. Simethicones demonstrated significantly higher drug survival compared to bulking agents (p = 0.009). Tricyclic antidepressants (TCA), loperamide, and simethicones all showed superior survival rates compared to osmotic laxatives (p = 0.039, p = 0.025 and p = 0.003, respectively). Additionally, loperamide and simethicones had better survival rates than antispasmodics (p = 0.046 and p = 0.012, respectively). At 60 months, the cumulative drug survival rate was highest for TCA (11%), followed by loperamide (10%) and simethicones (7%), all significantly outperforming bulking agents (1%) (p = 0.002 for TCA vs. bulking agents, p = 0.002 for loperamide vs. bulking agents, and p = 0.006 for simethicones vs. bulking agents). For all treatment-naïve attempts, the cumulative drug survival at 60 months was 6%.

Conclusions: The overall 60-month drug survival for treatments prescribed in IBS is relatively low, suggesting that the effectiveness of current therapies remains limited. Among the medications studied, simethicone and TCAs demonstrated the best drug survival rates.

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肠易激综合征推荐药物的药物生存期：一项回顾性观察研究。

背景：关于功能性肠病药物如何在临床实践中重新开处方的数据有限。本研究旨在调查不同肠易激综合征（IBS）治疗的患者在胃肠病学家的药物存活率。方法：通过回顾2010年至2018年间18-50岁诊断为IBS或未明确功能性肠道疾病的患者的病历，进行回顾性观察研究。采用Kaplan-Meier曲线和log-rank检验分析不同治疗类别的药物生存率。结果：529例患者共记录1528次治疗尝试，其中883例分类为treatment-naïve。与填充剂相比，西甲氧基酮的药物生存期显著提高（p = 0.009）。与渗透性泻药相比，三环抗抑郁药（TCA）、洛哌丁胺和西甲硅氧烷的生存率均优于渗透性泻药（p = 0.039、p = 0.025和p = 0.003）。此外，洛哌丁胺和西甲氧酮的生存率优于抗痉挛药物（p = 0.046和p = 0.012）。60个月时，TCA的累积药物生存率最高（11%），其次是洛哌丁胺（10%）和西甲硅氧烷（7%），均显著优于填充剂（1%）（TCA vs填充剂p = 0.002，洛哌丁胺vs填充剂p = 0.002，西甲硅氧烷vs填充剂p = 0.006）。对于所有treatment-naïve尝试，60个月的累积药物生存率为6%。结论：IBS处方治疗的总体60个月药物生存期相对较低，表明当前治疗的有效性仍然有限。在所研究的药物中，西甲硅氧烷和TCAs表现出最佳的药物生存率。

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来源期刊

Neurogastroenterology and Motility 医学-临床神经学

CiteScore

7.80

自引率

8.60%

发文量

178

审稿时长

3-6 weeks

期刊介绍： Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.