Elobixibat improves rectal sensation in patients with chronic constipation aged ≥60 years: a randomised placebo-controlled study.
bile acid
constipation
visceral sensitivity
Journal
BMJ open gastroenterology
ISSN: 2054-4774
Titre abrégé: BMJ Open Gastroenterol
Pays: England
ID NLM: 101660690
Informations de publication
Date de publication:
22 11 2023
22 11 2023
Historique:
received:
16
09
2023
accepted:
09
11
2023
medline:
24
11
2023
pubmed:
23
11
2023
entrez:
22
11
2023
Statut:
epublish
Résumé
High rectal sensory thresholds (RSTs) are associated with chronic constipation (CC), especially in older patients. Bile acids (BAs) affect the RSTs of healthy individuals. Here, we aimed to investigate the effects of the BA transporter inhibitor elobixibat in patients with CC aged ≥60 years. We prospectively compared the RSTs of 17 patients with CC aged ≥60 years with those of 9 healthy individuals of the same age range. We next performed a prospective, randomised, parallel-group, double-blind, placebo-controlled clinical trial of 17 patients with CC who administered elobixibat or placebo daily for 1 week. Using barostat methodology, their first constant sensation volume (FCSV), defaecatory desire volume (DDV), and maximum tolerable volume (MTV) thresholds; their rectal compliance; and their faecal BA concentrations were measured before and after treatment. There were no significant differences in the RSTs of healthy individuals and patients with CC, but all of these tended to be higher in the latter group. Elobixibat increased the desire to defaecate, significantly reduced the threshold for FCSV (p=0.0018), and tended to reduce the threshold for DDV (p=0.0899) versus placebo. However, there were no differences in the MTV or rectal compliance of the two groups. The total faecal BA concentration increased, and particularly that of secondary BAs in the elobixibat group. Elobixibat was most efficacious in participants with a longer duration of CC and a history of treatment for CC. Elobixibat reduces the RSTs of patients with CC aged ≥60 years, which may be important for its therapeutic effects. jRCTs061200030.
Identifiants
pubmed: 37993269
pii: bmjgast-2023-001257
doi: 10.1136/bmjgast-2023-001257
pmc: PMC10668193
pii:
doi:
Substances chimiques
elobixibat
865UEK4EJC
Dipeptides
0
Thiazepines
0
Bile Acids and Salts
0
Types de publication
Randomized Controlled Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: NM received honoraria from EA Pharma Co., Ltd. and Mochida Pharmaceutical Co., Ltd.
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