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Lubiprostone improves spontaneous bowel movements in CIC, OIC, and IBS-C, with additional benefits for abdominal pain in IBS-C.
A systematic review and meta-analysis by Umar Akram et al. has reaffirmed the effectiveness of lubiprostone in ameliorating various forms of constipation, including chronic idiopathic constipation (CIC), opioid-induced constipation (OIC), and irritable bowel syndrome with constipation (IBS-C).
Databases like Cochrane, MEDLINE, and Scopus were searched. Overall, 14 randomized controlled trials (RCTs) and 4,550 patients were included. After assessing studies using Cochrane’s Risk of Bias (RoB 2) tool, 12 studies were pooled for the meta-analysis. Results showed that lubiprostone markedly improved spontaneous bowel movements (SBM) in patients with CIC, with a risk ratio (RR) of 1.454 for SBM per week (95% confidence interval [CI] 1.193–1.771) and a RR of 1.790 for SBM within 24 hours (95% CI 1.491–2.150).
However, lubiprostone did not exhibit any pivotal effect on abdominal pain in CIC patients (RR 1.415, 95% CI 0.873–2.294). For OIC patients, lubiprostone was also found to prominently increase SBM within 24 hours (RR 1.277, 95% CI 1.105–1.475), but had no significant impact on abdominal pain (RR 4.321, 95% CI 0.624–29.941). In contrast, those with IBS-C experienced improvements across both SBM-related outcomes and abdominal pain, indicating that lubiprostone could be particularly beneficial for this group.
This comprehensive review highlights that lubiprostone improves SBM outcomes across all patient groups, while maintaining a good safety profile. Given its efficacy, it is recommended for use in combination regimens for managing CIC, IBS-C, and OIC, offering a reliable treatment option for these challenging constipation-related ailments.
JGH Open
The Efficacy of Lubiprostone in Patients of Constipation: An Updated Systematic Review and Meta-Analysis
Umar Akram et al.
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