Efficacy and safety of alosetron in women with irritable bowel syndrome: a randomised, placebo-controlled trial.

Abstract

BACKGROUND:

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with symptoms of abdominal pain, discomfort, and altered bowel function. Antagonists of the type 3 serotonin receptor (5-HT3) have shown promising results in the relief of IBS-associated symptoms. We aimed to confirm these findings by doing a randomised, placebo-controlled trial.

METHODS:

We studied 647 female IBS patients with diarrhoea-predominant or alternating bowel patterns (diarrhoea and constipation). 324 patients were assigned 1 mg alosetron and 323 placebo orally twice daily for 12 weeks, followed by a 4-week post-treatment period. Adequate relief of abdominal pain and discomfort was the primary endpoint; secondary endpoints included improvements in urgency, stool frequency, and stool consistency. Analysis was by intention to treat.

FINDINGS:

79 (24%) of patients in the alosetron group and 53 (16%) in the placebo group dropped out. The difference in the drop-out rate between groups was mainly due to a greater occurrence of constipation in the alosetron group. A greater proportion of alosetron-treated patients than placebo-treated patients (133 [41%] vs 94 [29%], respectively) reported adequate relief for all 3 months of treatment (difference 12% [4.7-19.2]). Alosetron also significantly decreased urgency and stool frequency, and increased stool firmness. Constipation occurred in 30% and 3% of patients in the alosetron and placebo groups, respectively.

INTERPRETATION:

Alosetron was well tolerated and clinically effective in alleviating pain and bowel-related symptoms in this population of women with IBS.

• Authors: M Camilleri, A R Northcutt, S Kong, G E Dukes, D McSorley, A W Mangel
• Journal: Lancet (London, England) (Lancet) Vol. 355 Issue 9209 Pg. 1035-40 (Mar 25 2000) ISSN: 0140-6736 [Print] England
• PMID: 10744088 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Carbolines
• Receptors, Serotonin
• Receptors, Serotonin, 5-HT3
• Serotonin Antagonists
• alosetron

Topics

• Administration, Oral
• Adult
• Carbolines (adverse effects, therapeutic use)
• Colonic Diseases, Functional (diagnosis, drug therapy)
• Drug Administration Schedule
• Female
• Gastrointestinal Transit (drug effects)
• Humans
• Middle Aged
• Receptors, Serotonin (drug effects)
• Receptors, Serotonin, 5-HT3
• Serotonin Antagonists (adverse effects, therapeutic use)
• Treatment Outcome