¿Ayuda la amitriptilina para el manejo del dolor del síndrome del intestino irritable?: Una revisión sistemática y...

Área de la Ciencia:

• Gastroenterology; Pharmacology; Clinical Medicine

Sus antecedentes:

• Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder globally.
• Amitriptyline is a frequently used second-line pharmacological agent for managing IBS symptoms.
• Evidence regarding the pain-therapeutic efficacy of amitriptyline in IBS requires consolidation.

Objetivo del estudio:

• To systematically review and meta-analyze the existing evidence on the pain therapeutic efficacy of amitriptyline in adult patients diagnosed with IBS.
• To consolidate current research findings on amitriptyline's effectiveness in alleviating IBS-related pain.

Principales métodos:

• An updated systematic review and meta-analysis adhering to PRISMA guidelines.
• Searched four major databases (PubMed, Scopus, Web of Science, Cochrane) from inception to March 15, 2024.
• Included observational studies and randomized controlled trials.

Principales resultados:

• Analyzed 15 studies with 1497 IBS patients; 12 studies were included in the meta-analysis.
• Pooled improvement rate for amitriptyline was 66.61% (fixed model, p=0.31, I²=55%).
• Amitriptyline showed a statistically significant pooled odds ratio of 2.07 over placebo (fixed model, p=0.40, I²=1%) for pain management.

Conclusiones:

• Amitriptyline demonstrates significant short-term efficacy in improving abdominal pain and global IBS symptoms.
• The certainty of evidence is limited by short follow-up periods, variable study quality, and incomplete safety reporting.
• Further well-designed, longer-term trials with standardized outcomes and adverse event monitoring are necessary.