Efficacy, long-term safety, and impact on quality of life of elobixibat in more severe constipation: Post hoc analyses of two phase 3 trials in Japan.
abdominal pain
bile acid
constipation-predominant irritable bowel syndrome
quality of life
spontaneous bowel movement
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
received:
19
11
2018
revised:
07
01
2019
accepted:
22
01
2019
pubmed:
23
2
2019
medline:
14
4
2020
entrez:
23
2
2019
Statut:
ppublish
Résumé
In two phase 3 trials, elobixibat, a locally acting ileal bile acid transporter inhibitor, resolved constipation and was well tolerated in Japanese patients with chronic constipation. We analyzed the efficacy, safety, and impact on quality of life (QOL) of elobixibat in patients with symptomatically more severe constipation in the two phase 3 trials. This post hoc analysis of elobixibat treatment outcomes included data from a 2-week, randomized, placebo-controlled, phase 3 trial (10 mg/d), and a 52-week, open-label trial (5-15 mg/d) in subgroups with severe constipation defined as ≤2 spontaneous bowel movements (SBMs) and ≤3 Bristol Stool Form Scale score during the second week of the 2-week run-in period. We also analyzed the rates of abdominal pain, diarrhea, and QOL in subgroups according to sex, presence of constipation-predominant irritable bowel syndrome (IBS-C) and side effects. In patients with severe constipation, there was significant improvement in the 10 mg elobixibat group compared to the placebo group in change in SBMs from baseline at week 1 (primary endpoint) of the 2-week trial. The differences between groups were reduced in patients with more severe constipation. Increasing the dose to 15 mg was effective for more severe constipation in improving the number of SBMs per week in the 52-week trial. Overall, elobixibat was well tolerated and improved QOL scores, irrespective of gender, presence of IBS-C or side effects. Elobixibat is effective for symptomatically severe constipation, is well tolerated and improves QOL, irrespective of potentially confounding patient characteristics.
Sections du résumé
BACKGROUND
In two phase 3 trials, elobixibat, a locally acting ileal bile acid transporter inhibitor, resolved constipation and was well tolerated in Japanese patients with chronic constipation. We analyzed the efficacy, safety, and impact on quality of life (QOL) of elobixibat in patients with symptomatically more severe constipation in the two phase 3 trials.
METHODS
This post hoc analysis of elobixibat treatment outcomes included data from a 2-week, randomized, placebo-controlled, phase 3 trial (10 mg/d), and a 52-week, open-label trial (5-15 mg/d) in subgroups with severe constipation defined as ≤2 spontaneous bowel movements (SBMs) and ≤3 Bristol Stool Form Scale score during the second week of the 2-week run-in period. We also analyzed the rates of abdominal pain, diarrhea, and QOL in subgroups according to sex, presence of constipation-predominant irritable bowel syndrome (IBS-C) and side effects.
KEY RESULTS
In patients with severe constipation, there was significant improvement in the 10 mg elobixibat group compared to the placebo group in change in SBMs from baseline at week 1 (primary endpoint) of the 2-week trial. The differences between groups were reduced in patients with more severe constipation. Increasing the dose to 15 mg was effective for more severe constipation in improving the number of SBMs per week in the 52-week trial. Overall, elobixibat was well tolerated and improved QOL scores, irrespective of gender, presence of IBS-C or side effects.
CONCLUSIONS & INFERENCES
Elobixibat is effective for symptomatically severe constipation, is well tolerated and improves QOL, irrespective of potentially confounding patient characteristics.
Identifiants
pubmed: 30793431
doi: 10.1111/nmo.13571
pmc: PMC6519041
doi:
Substances chimiques
Dipeptides
0
Gastrointestinal Agents
0
Thiazepines
0
elobixibat
865UEK4EJC
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13571Subventions
Organisme : NIDDK NIH HHS
ID : R01 DK067071
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK115950
Pays : United States
Informations de copyright
© 2019 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd.
Références
Am J Physiol Gastrointest Liver Physiol. 2002 Mar;282(3):G443-9
pubmed: 11841994
Gut. 1988 Sep;29(9):1173-9
pubmed: 3197990
Therap Adv Gastroenterol. 2014 Jul;7(4):167-75
pubmed: 25057297
Am J Gastroenterol. 2011 Dec;106(12):2154-64
pubmed: 21876564
Clin Sci Mol Med. 1973 Nov;45(5):593-606
pubmed: 4759510
Br J Clin Pharmacol. 2018 Oct;84(10):2393-2404
pubmed: 29959787
Neurogastroenterol Motil. 2010 Dec;22(12):e340-9
pubmed: 20879994
Gastroenterology. 2013 Jan;144(1):218-38
pubmed: 23261065
Neurogastroenterol Motil. 2019 May;31(5):e13571
pubmed: 30793431
Neurogastroenterol Motil. 2010 Mar;22(3):293-e82
pubmed: 20025692
Gastroenterology. 2016 Feb 18;:
pubmed: 27144627
Lancet Gastroenterol Hepatol. 2018 Aug;3(8):537-547
pubmed: 29805116
Am J Gastroenterol. 2011 Oct;106(10):1803-12
pubmed: 21606974
Am J Gastroenterol. 2010 Feb;105(2):403-11
pubmed: 19888202
J Gastroenterol. 2018 Apr;53(4):525-534
pubmed: 28840422
Gut. 2012 Aug;61(8):1132-9
pubmed: 22180057
J Neurogastroenterol Motil. 2016 Oct 30;22(4):677-685
pubmed: 27426278
Gut. 2011 Feb;60(2):209-18
pubmed: 21205879
Dis Colon Rectum. 1999 Nov;42(11):1401-8; discussion 1408-10
pubmed: 10566527
J Neurogastroenterol Motil. 2017 Oct 30;23(4):561-568
pubmed: 28738452
Dig Dis Sci. 2011 Sep;56(9):2688-95
pubmed: 21380761
Clin Gastroenterol Hepatol. 2013 Oct;11(10):1270-1275.e1
pubmed: 23639599
Gastroenterology. 2006 Apr;130(5):1480-91
pubmed: 16678561
Neurogastroenterol Motil. 2018 Dec;30(12):e13448
pubmed: 30129138
J Lab Clin Med. 1979 Nov;94(5):661-74
pubmed: 501195
Am J Gastroenterol. 2004 Dec;99(12):2405-16
pubmed: 15571589
Am J Gastroenterol. 2004 Apr;99(4):750-9
pubmed: 15089911
Clin Gastroenterol Hepatol. 2018 Apr;16(4):522-527
pubmed: 28666948