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Early Therapeutic Response Predicts Outcome in Chronic Constipation: A Multicenter Prospective Observational Study.

Tadayuki Oshima1,2,3, Seiji Futagami4,3, Yoshimasa Tanaka5,3

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Summary

Early treatment response in chronic constipation is key. Patients not responding to therapy within two weeks are likely to have poorer outcomes at four weeks, highlighting the importance of early efficacy assessment.

Keywords:
Chronic constipationPatient-reported outcomePatient’s impressionPredictive accuracySpontaneous bowel movement

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Area of Science:

  • Gastroenterology
  • Clinical Pharmacology

Background:

  • Chronic constipation affects quality of life and is common in clinical practice.
  • Predictors of treatment efficacy for chronic constipation are not well understood.
  • Identifying these predictors is crucial for optimizing patient care.

Purpose of the Study:

  • To identify factors that predict successful treatment outcomes in patients with chronic constipation.
  • To determine if early treatment response can predict long-term efficacy.

Main Methods:

  • A multicenter, prospective observational study was conducted.
  • Patients with chronic constipation (moderate to severe) were assessed using the CC-TEST questionnaire.
  • Multivariate analyses identified predictive factors based on patient's impression, symptom intensity (NRS), and spontaneous bowel movement (SBM) frequency at 2 and 4 weeks post-treatment.

Main Results:

  • 97 patients received constipation medications, showing significant symptom improvement at 2 and 4 weeks.
  • Early treatment response at 2 weeks, specifically non-responsiveness, was a significant predictor of poorer patient impression and outcomes for NRS and SBM.
  • Incorporating 2-week non-responsiveness improved the predictive accuracy for 4-week treatment efficacy.

Conclusions:

  • The therapeutic response observed at two weeks is the most significant predictor of subsequent treatment response at four weeks.
  • Early assessment of treatment efficacy in chronic constipation is crucial for predicting long-term outcomes.
  • This finding can help clinicians tailor treatment strategies more effectively.