Related Experiment Video
Updated: Feb 20, 2026
Perturbations of Circulating miRNAs in Irritable Bowel Syndrome Detected Using a Multiplexed High-throughput Gene Expression Platform
Published on: November 30, 2016
A Systematic Review of Efficacy in Irritable Bowel Syndrome: How the Number Needed to Treat May be a Misleading
Jonathan A Busam1, Nisha Batta1, Ali Rezaie2,3
1Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Introduction:
Using the number needed to treat (NNT) to compare pharmacotherapies for irritable bowel syndrome (IBS) is complicated by evolving trial endpoints. Standardizing NNT estimates across these endpoints, including future development of a conversion framework linking historical subjective measures to contemporary Food and Drug Administration (FDA) response criteria, may improve the validity of therapeutic efficacy comparisons.
Methods:
PubMed, Web of Science, and Cochrane databases were searched through October 2024 to identify placebo-controlled clinical trials investigating IBS pharmacotherapies that reported both the subjective adequate relief and contemporary FDA endpoints. Calculated NNTs were compared between different endpoints for the same trials and across the same endpoints for different indications using a random-effects model.
Results:
Among the 15 included trials, the FDA endpoint NNT was on average 2 units higher than the subjective adequate global relief endpoint ( P < 0.01) and no significant NNT differences were noted between tricyclics and other therapies ( P = 0.41). When using the subjective relief endpoint to enable the inclusion of tricyclics, the NNTs for drugs for constipation-predominant IBS, diarrhea-predominant IBS, and IBS global symptoms were 5 ( P < 0.0001), 8 ( P < 0.0001), and 8 ( P = 0.001), respectively.
Discussion:
When standardized endpoints are used, the NNTs for included IBS pharmacotherapies are similar across indications. Failure to account for endpoint heterogeneity in clinical trials for IBS may distort comparative effectiveness conclusions, undermining clinical decision-making.
More Related Videos
04:04Electroacupuncture Combined with Chinese Medicine Ironing Therapy for Functional Constipation
Published on: July 5, 2024
09:44Functional Assessment of Intestinal Motility and Gut Wall Inflammation in Rodents: Analyses in a Standardized Model of Intestinal Manipulation
Published on: September 11, 2012
Related Concept Videos
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:30Irritable Bowel Syndrome III: Medical and Nursing Management
01:21Drugs for Treatment of Constipation-Predominant IBS
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...