New therapeutic options for IBS: the role of the first in class mixed µ- opioid receptor agonist and δ-opioid receptor antagonist (mudelta) eluxadoline

ABSTRACT

Introduction: Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder which represents a major cost to healthcare services. IBS-D patients represent about one-third of the IBS population and are currently treated with antispasmodics, loperamide, bile acid sequestrants and antidepressants. Alosetron and rifaximin are also available in USA, ramosetron in Japan, Korea and Thailand and ondansetron as an off-label treatment.

Areas covered: This article focuses on eluxadoline, a novel pharmacological agent that has recently been approved by both the FDA and EMA for treatment of patients with IBS-D.

Expert commentary: The efficacy and safety of eluxadoline in treating bowel habit alterations and pain, both in the short and long-term, make the drug a welcome addition to our therapeutic alternatives in IBS-D. Its positioning in any IBS algorithm will depend on the ‘real world’ prevalence of the small risk of sphincter of Oddi spasm and mild pancreatitis.

KEYWORDS:

• IBS treatment
• pain
• diarrhoea
• eluxadoline
• muDelta

Information resources

A literature search was carried out using Medline and PubMed. Further information was gathered by searching on ClinicalTrials.gov and for any information provided by the Allergan. The paper was also checked for accuracy by Allergan but the company was not allowed to comment on content or any opinions expressed by the authors.

Declaration of interest

M. Corsetti is a speaker for Shire and Menarini and a consultant for Allergan. P. Whorwell has acted as a consultant for, or received research grant support from, the following pharmaceutical companies in the last 5 years: Almirall Pharma, Boehringer-Ingelheim, Chr. Hansen, Danone Research, Ironwood Pharmaceuticals, Salix, Shire UK, Sucampo Pharmaceuticals and Allergan. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.