AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation.

Antispasmodic Irritable Bowel Syndrome Linaclotide Lubiprostone Meta-Analysis Plecanatide Polyethylene Glycol Quality of Life Randomized Controlled Trial Selective Serotonin Reuptake Inhibitor Symptoms Tegaserod Tenapanor Treatment Tricyclic Antidepressant

Journal

Gastroenterology
ISSN: 1528-0012
Titre abrégé: Gastroenterology
Pays: United States
ID NLM: 0374630

Informations de publication

Date de publication:
07 2022
Historique:
entrez: 23 6 2022
pubmed: 24 6 2022
medline: 28 6 2022
Statut: ppublish

Résumé

Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction associated with significant disease burden. This American Gastroenterological Association guideline is intended to support practitioners in decisions about the use of medications for the pharmacological management of IBS-C and is an update of a prior technical review and guideline. The Grading of Recommendations Assessment, Development and Evaluation framework was used to assess evidence and make recommendations. The technical review panel prioritized clinical questions and outcomes according to their importance for clinicians and patients and conducted an evidence review of the following agents: tenapanor, plecanatide, linaclotide, tegaserod, lubiprostone, polyethylene glycol laxatives, tricyclic antidepressants, selective serotonin reuptake inhibitors, and antispasmodics. The Guideline Panel reviewed the evidence and used the Evidence-to-Decision Framework to develop recommendations. The panel agreed on 9 recommendations for the management of patients with IBS-C. The panel made a strong recommendation for linaclotide (high certainty) and conditional recommendations for tenapanor, plecanatide, tegaserod, and lubiprostone (moderate certainty), polyethylene glycol laxatives, tricyclic antidepressants, and antispasmodics (low certainty). The panel made a conditional recommendation against the use of selective serotonin reuptake inhibitors (low certainty).

Sections du résumé

BACKGROUND & AIMS
Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction associated with significant disease burden. This American Gastroenterological Association guideline is intended to support practitioners in decisions about the use of medications for the pharmacological management of IBS-C and is an update of a prior technical review and guideline.
METHODS
The Grading of Recommendations Assessment, Development and Evaluation framework was used to assess evidence and make recommendations. The technical review panel prioritized clinical questions and outcomes according to their importance for clinicians and patients and conducted an evidence review of the following agents: tenapanor, plecanatide, linaclotide, tegaserod, lubiprostone, polyethylene glycol laxatives, tricyclic antidepressants, selective serotonin reuptake inhibitors, and antispasmodics. The Guideline Panel reviewed the evidence and used the Evidence-to-Decision Framework to develop recommendations.
CONCLUSIONS
The panel agreed on 9 recommendations for the management of patients with IBS-C. The panel made a strong recommendation for linaclotide (high certainty) and conditional recommendations for tenapanor, plecanatide, tegaserod, and lubiprostone (moderate certainty), polyethylene glycol laxatives, tricyclic antidepressants, and antispasmodics (low certainty). The panel made a conditional recommendation against the use of selective serotonin reuptake inhibitors (low certainty).

Identifiants

pubmed: 35738724
pii: S0016-5085(22)00390-0
doi: 10.1053/j.gastro.2022.04.016
pii:
doi:

Substances chimiques

Antidepressive Agents, Tricyclic 0
Gastrointestinal Agents 0
Laxatives 0
Parasympatholytics 0
Serotonin Uptake Inhibitors 0
Polyethylene Glycols 3WJQ0SDW1A
Lubiprostone 7662KG2R6K

Types de publication

Practice Guideline Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

118-136

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022. Published by Elsevier Inc.

Auteurs

Lin Chang (L)

Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California.

Shahnaz Sultan (S)

Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota; Veterans Affairs Healthcare System, Minneapolis, Minnesota.

Anthony Lembo (A)

Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

G Nicholas Verne (GN)

Department of Medicine, University of Tennessee College of Medicine, Memphis, Tennessee.

Walter Smalley (W)

Department of Medicine, Division of Gastroenterology, Vanderbilt University, Nashville, Tennessee.

Joel J Heidelbaugh (JJ)

Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.

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Classifications MeSH