Lubiprostone for chronic idiopathic constipation and irritable bowel syndrome with constipation

Abstract

Lubiprostone, a locally acting highly selective type-2 chloride channel activator, has been US FDA approved since January 2006 for the treatment of adults with chronic idiopathic constipation and FDA approved since April 2008 for the treatment of woman aged 18 years or older suffering from irritable bowel syndrome (IBS) with constipation. Through activation of the type-2 chloride channels located on the luminal side of intestinal epithelial cells, it promotes fluid secretion, increasing the liquid content of stool and accelerating small bowel as well as colonic transit. Lubiprostone has demonstrated efficacy with respect to increasing weekly spontaneous bowel movements and improving stool consistency, straining and constipation severity, both in short- and long-term studies. It has also demonstrated efficacy in the treatment of IBS with constipation, with beneficial effects on global symptoms, abdominal pain, constipation-related symptoms and overall quality of life. There is no evidence of a rebound in constipation or IBS symptoms following cessation of lubiprostone. In general, lubiprostone is well tolerated, with the most common side effects including nausea, headache and diarrhea.

Keywords::

• chloride channel
• constipation
• irritable bowel syndrome
• lubiprostone

Financial & competing interests disclosure

William Chey is on the speaker’s bureau for Novartis, Salix, and Takeda; and is a consultant for Allergan, AGI, Novartis, Pharmos, Salix, and Takeda. 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.

No writing assistance was utilized in the production of this manuscript.

Notes

Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.

Data from [8].

^*Criteria must be fulfilled for last 3 months with symptom onset at least 6 months prior to diagnosis

Data from [8].

IBS: Irritable bowel syndrome; IBS-C: Irritable bowel syndrome with constipation.