A comprehensive assessment of Lubiprostone, Linaclotide, and Elobixibat for chronic constipation revealed comparable efficacy but distinct safety profiles, offering insights for personalized treatment strategies in clinical practice. Researchers conducted a systematic literature review and meta-analysis to examine the effectiveness, safety, and impact on quality of life of three commonly prescribed medications: Elobixibat (10 mg or 15 mg), Linaclotide (145 mcg or 500 mcg), and Lubiprostone (48 mcg).

The study, published in BMC Gastroenterology, involved rigorous searches across PubMed and Embase utilizing the Ovid platform. Furthermore, analyses for the the number needed to treat (NNT) and the number needed to harm (NNH) were carried out. Primary metrics included efficacy in terms of spontaneous bowel movement improvement. Secondary outcomes comprised safety evaluation, assessment of constipation-linked symptoms, and evaluation of quality of life. The systematic literature review identified 24 studies that met the inclusion criteria, consisting of 4 observational studies, 17 randomized controlled trials (RCTs), and 3 single-arm trials.

Following a feasibility assessment for the meta-analysis, 14 studies were available for safety data analysis, while 8 studies were available for efficacy analysis. Despite differences in mechanisms of action, Lubiprostone, Linaclotide, and Elobixibat illustrated comparable efficacy in increasing spontaneous bowel movements, as revealed by the meta-analysis and NNT analysis. While the three drugs displayed similar efficacy, their safety profiles varied considerably.

Lubiprostone was associated with a higher risk of nausea, Linaclotide with diarrhea, and Elobixibat with abdominal pain, as indicated by the NNH analysis. The findings of this study offer valuable insights for healthcare providers, enabling them to adopt an individualized approach when selecting the most suitable treatment for patients with chronic constipation. By considering both efficacy and safety profiles, physicians can tailor treatment regimens to meet the unique needs of each patient, thereby improving overall outcomes and enhancing patient satisfaction.