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Use of Prucalopride for Chronic Constipation: A Systematic Review and Meta-analysis of Published Randomized,
Muhammad S Sajid1, Madhu Hebbar1, Mirza K Baig1
1Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing Hospital, Worthing, UK.
Journal of Neurogastroenterology and Motility
|April 30, 2016
Summary
Prucalopride effectively treats chronic constipation by increasing bowel movement frequency. While associated with increased side effects, it offers clinical benefits for laxative-resistant cases.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Chronic constipation affects a significant patient population, impacting quality of life.
- Current management strategies for chronic constipation include lifestyle changes and laxatives, with varying efficacy.
- Laxative-resistant constipation presents a therapeutic challenge requiring alternative pharmacotherapies.
Approach:
- A meta-analysis was conducted on 16 randomized, controlled trials involving 3943 patients.
- Data from published trials were synthesized to evaluate the efficacy and safety of prucalopride.
- Statistical methods, including standardized mean difference (SMD) and odds ratio (OR), were employed.
Key Points:
- Prucalopride demonstrated a statistically significant increase in spontaneous bowel movements per week across doses of 1 mg, 2 mg, and 4 mg.
- The standardized mean difference (SMD) for increased bowel movements ranged from 0.33 to 0.42, indicating a moderate effect.
- Adverse events, including headache, abdominal cramps, and diarrhea, were more frequent in the prucalopride group (OR, 1.70).
Conclusions:
- Prucalopride is a clinically beneficial pharmacotherapy for managing chronic constipation.
- Its routine use can be considered for patients with chronic simple laxative-resistant constipation.
- Further research may explore optimal dosing strategies and long-term safety profiles.
