Rubio CE, Cerda RE, Minero AJI

Language: Spanish
References: 8
Page: 205-212
PDF size: 213.70 Kb.

ABSTRACT

Introduction: Irritable bowel syndrome (IBS) affects 5-20% of all individuals around the world. In Mexico (Veracruz), a prevalence of 16.9% has been documented. Its diagnosis is based on the Rome III criteria, and its treatment has different approaches; within the pharmacological options are the serotonin receptor agonist drugs (5-HT4). The effectiveness of tegaserod has been established in patients with IBS with constipation (IBS-C), considering prucalopride as a drug with therapeutic potential for this condition, since it shows greater affinity for the 5-HT4 receptor than tegaserod, and accelerates colonic transit. However, more data from randomized controlled trials that prove this are required. Objective: To compare the efficacy of prucalopride versus tegaserod in the treatment of irritable bowel with constipation, by means of the Bristol scale, the global scale of symptoms and associated symptoms. Material and methods: Two groups of patients were established (A and B) in a randomized manner: men and women between 18 and 50 years of age with Rome criteria III for IBS-C; all were given the same diet. In group A, Prucalopride was administered at a dose of 2 mg orally every 24 hours for two weeks. In group B, 6 mg of tegaserod were administered every 12 hours for two weeks. The clinical evolution of each patient was assessed each week during the two weeks of the study period, including the assessments of the adapted and validated Bristol scale, and the global scale of symptoms and associated symptoms. Results: Twenty-two patients were included, 21 (95.5%) female, with a 1:21 ratio; the average age was 37.27 years; 11 (50%) received prucalopride, and the rest, tegaserod. To evaluate the association between the treatment given and the symptoms of «rectal fullness, evacuation effort and evacuation urgency», Fisher’s exact test was used, being not statistically significant (p › 0.05); for «abdominal distension, abdominal movements and Bristol scale», Mann-Whitney U was used, being not statistically significant (p › 0.05); however, for «abdominal pain», with the same test, a statistically significant difference was found (p ‹ 0.05). Of those treated with prucalopride, one (9%) had diarrhea, three (27%) headache, and one (9%) headache and nausea; with tegaserod, two (18%) had diarrhea, two (18%) headache, and one (9%) headache and nausea. Conclusions: Both, prucalopride and tegaserod improve to some degree all the symptoms evaluated for IBS-C, but prucalopride significantly and more promptly improves the symptom of «abdominal pain». It was evidenced that the diarrhea event implied change of treatment in both groups.

REFERENCES

1. Magdy El-Salhy. Irritable bowel syndrome: diagnosis and pathogenesis. World J Gastroenterol. 2012; 18 (37): 5151-5163.

2. Valerio-Ureña J, Vásquez-Fernández F, Jiménez-Pineda A, Cortázar-Benítez LF, Azamar-Jácome AA, Duarte Velázquez ME et al. Prevalencia del SII en población abierta de la ciudad de Veracruz, México. Rev Gastroenterol Mex. 2010; 75 (1): 36-41.

3. Enríquez BH, Rodríguez JT, Schneider ER. Síndrome de intestino irritable y otros trastornos relacionados. Ed. Panamericana; 2010. p. 27.

4. Halland M, Talley NJ. New treatments for IBS. Nat Rev Gastroenterol Hepatol. 2013; 10: 13-23.

5. Wood P. Tegaserod in the treatment of constipation-predominant irritable bowel syndrome. Do the risks outweigh the benefits? Naunyn Schmiedeberg Arch Pharmacol. 2012; 385: 1-3.

6. Schmulson M, Chang L. Review article: the treatment of functional abdominal bloating and distension. Alimenta Pharmacol Ther. 2011; 33: (10): 1071-1086.

7. Quigley EM. Prucalopride: safety, efficacy and potential applications. Therapeutic Advances in Gastroenterology. 2012; 5 (1): 23-30.

8. Tack J, van Outryve M, Beyens G, Kerstens R, Vandeplassche L. Prucalopride (Resolor) in the treatment of severe chronic constipation in patients dissatisfied with laxatives. Neurogastroenterology. 2009; 58: 357-365.