Abstract
IntroductionIrritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic or recurrent abdominal pain in association with defecation or a change in bowel habits. A predominant disorder of bowel habits, IBS is classified into three main subtypes: constipation-predominant IBS (IBS-C), diarrhea-predominant IBS (IBS-D) and IBS alternating between constipation and diarrhea (IBS-M). Linaclotide is a first-in-class, oral, once-daily guanylate cyclase-C receptor agonist (GC-CA) that is licensed for the symptomatic treatment of moderate-to-severe IBS-C in adults. This review aims to facilitate and optimize clinical practices, establishing common guidelines to monitor patients with IBS-C that are treated with linaclotide.MethodsA group of experts in functional digestive disorders was convened to review the efficacy and safety of linaclotide and to develop an updated consensus report for the treatment of patients with IBS-C. A search was performed for English, French and Spanish language articles in PubMed. On the basis of the articles identified, an initial document was drafted addressing different issues frequently raised by general practitioners and GI specialists that are related to the prescription, efficacy and safety of linaclotide. This document was then reviewed and modified by the expert panel until a final text was agreed upon and validated.ResultsBased on the evidence, the panel addressed the following recommendations: (1) Linaclotide is indicated for the treatment of moderate to severe IBS-C in adults; (2) it is recommended that patients take linaclotide continuously and not sporadically; (3) patients should be warned about the risk of diarrhea and given choices concerning how to deal with this possible side effect; (4) the absence of tachyphylaxis or potential risks implies that linaclotide treatment can be maintained for long periods of time.ConclusionsThis document seeks to lay down a set of recommendations and to identify key issues that may be useful for the clinical management of IBS-C patients treated with linaclotide.
Highlights
Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic or recurrent abdominal pain in association with defecation or a change in bowel habits
The strategy to manage IBS-C patients with linaclotide and an overview of the recommendations proposed by the expert panel are summarized in Tables 1 and 2, respectively
According to the summary of the product’s characteristics (SmPC), linaclotide is indicated for the treatment of adults with moderate to severe symptomatic IBS-C
Summary
Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic or recurrent abdominal pain in association with defecation or a change in bowel habits. J. Serra Motility and Functional Gut Disorders Unit, Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), University Hospital Germans Trias i Pujol, Barcelona, Spain distention and associated with defecation or a change in bowel habits (i.e., constipation, diarrhea, or a mix of constipation and diarrhea) [1]. Serra Motility and Functional Gut Disorders Unit, Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), University Hospital Germans Trias i Pujol, Barcelona, Spain distention and associated with defecation or a change in bowel habits (i.e., constipation, diarrhea, or a mix of constipation and diarrhea) [1] This is a relatively common gastrointestinal disorder detected worldwide, and its prevalence in the general population ranges from 3% to 21% depending on the criteria used to define IBS. The health-related quality of life (HR-QoL) of IBS patients is relatively low, comparable to that of patients with diabetes and heart failure/defect who have a high rate of mortality [5]
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