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Published in: Digestive Diseases and Sciences 9/2011

Open Access 01-09-2011 | Original Article

Long-Term Safety and Effectiveness of Lubiprostone, a Chloride Channel (ClC-2) Activator, in Patients with Chronic Idiopathic Constipation

Authors: Anthony J. Lembo, John F. Johanson, Henry P. Parkman, Satish S. Rao, Philip B. Miner Jr., Ryuji Ueno

Published in: Digestive Diseases and Sciences | Issue 9/2011

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Abstract

Background

Lubiprostone helps relieve constipation in short-term 4-week studies. There are limited data on long-term pharmacological treatment with lubiprostone for chronic idiopathic constipation.

Aims

To examine the long-term safety and effectiveness of lubiprostone in patients with chronic idiopathic constipation.

Methods

In this prospective, multicenter, open-labeled trial, 248 patients aged ≥18 years with chronic idiopathic constipation were directed to take lubiprostone 24 mcg BID as needed for 48 weeks. Patients were allowed to decrease the dose in response to the perceived severity of constipation and need for relief. Hematology and chemistry profiles and assessment of constipation symptoms and its severity were performed at all visits. Adverse events (AEs) were recorded.

Results

Of the 248 patients who entered the trial, 127 (51%) completed the trial. A dose reduction was observed in 17% of the patients, resulting in an average study medication exposure across the study of approximately 1.7 capsules (or approximately 40.8 mcg) per day. The most common treatment-related AEs were nausea (19.8%), diarrhea (9.7%), abdominal distension (6.9%), headache (6.9%), and abdominal pain (5.2%). No deaths were reported and of the 16 reported serious AEs, one was considered possibly treatment related. Average changes in serum electrolytes were not clinically relevant at any time point during the study. On average, lubiprostone significantly (p < 0.0001) reduced patient-reported constipation severity, abdominal bloating, and abdominal discomfort across 48 weeks when compared to baseline.

Conclusions

During this 48-week open-label study, lubiprostone was well tolerated. Bowel symptoms consistently improved over 48 weeks in adult patients with chronic idiopathic constipation.
Literature
1.
go back to reference Sonnenberg A, Koch TR. Epidemiology of constipation in the United States. Dis Colon Rectum. 1989;32:1–8.PubMedCrossRef Sonnenberg A, Koch TR. Epidemiology of constipation in the United States. Dis Colon Rectum. 1989;32:1–8.PubMedCrossRef
2.
go back to reference Stewart W, Liberman J, Sandler RS, et al. Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol. 1999;94:3530–3540.PubMedCrossRef Stewart W, Liberman J, Sandler RS, et al. Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol. 1999;94:3530–3540.PubMedCrossRef
3.
go back to reference Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750–759.PubMedCrossRef Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750–759.PubMedCrossRef
4.
go back to reference Martin BC. National estimates of office and emergency room constipation-related visits in the United States. Am J Gastroenterol. 2004;99:S244. Abstract.CrossRef Martin BC. National estimates of office and emergency room constipation-related visits in the United States. Am J Gastroenterol. 2004;99:S244. Abstract.CrossRef
5.
go back to reference Talley NJ, Zinsmeister AR, Van Dyke C, Melton LJ III. Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroenterology. 1991;101:927–934.PubMed Talley NJ, Zinsmeister AR, Van Dyke C, Melton LJ III. Epidemiology of colonic symptoms and the irritable bowel syndrome. Gastroenterology. 1991;101:927–934.PubMed
6.
go back to reference Talley NJ. Differentiating functional constipation from constipation-predominant irritable bowel syndrome: management implications. Rev Gastroenterol Disord. 2005;5:1–9.PubMed Talley NJ. Differentiating functional constipation from constipation-predominant irritable bowel syndrome: management implications. Rev Gastroenterol Disord. 2005;5:1–9.PubMed
7.
go back to reference Muller-Lissner SA, Kamm MA, Scarpignato C, et al. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005;100:232–242.PubMedCrossRef Muller-Lissner SA, Kamm MA, Scarpignato C, et al. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005;100:232–242.PubMedCrossRef
9.
go back to reference Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ. Systematic review on the management of chronic constipation in North America. Am J Gastroenterol. 2005;100:S5–S21.PubMedCrossRef Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ. Systematic review on the management of chronic constipation in North America. Am J Gastroenterol. 2005;100:S5–S21.PubMedCrossRef
10.
go back to reference Lacy BE, Chey WD. Lubiprostone: Chronic constipation and irritable bowel syndrome with constipation. Expert Opin Pharmacother. 2009;10:143–152.PubMedCrossRef Lacy BE, Chey WD. Lubiprostone: Chronic constipation and irritable bowel syndrome with constipation. Expert Opin Pharmacother. 2009;10:143–152.PubMedCrossRef
11.
go back to reference MiraLAX. Package insert, Schering-Plough HealthCare Products Inc. 2011. MiraLAX. Package insert, Schering-Plough HealthCare Products Inc. 2011.
12.
go back to reference Jentsch TJ, Poet M, Fuhrmann JC, Zdebik AA. Physiological functions of ClC Cl- channels gleaned from human genetic disease and mouse models. Annu Rev Physiol. 2005;67:779–807.PubMedCrossRef Jentsch TJ, Poet M, Fuhrmann JC, Zdebik AA. Physiological functions of ClC Cl- channels gleaned from human genetic disease and mouse models. Annu Rev Physiol. 2005;67:779–807.PubMedCrossRef
13.
go back to reference Cuppoletti J, Malinowska DH, Tewari KP, et al. SPI-0211 activates T84 cell chloride transport and recombinant human ClC-2 chloride currents. Am J Physiol Cell Physiol. 2004;287:C1178–C1183.CrossRef Cuppoletti J, Malinowska DH, Tewari KP, et al. SPI-0211 activates T84 cell chloride transport and recombinant human ClC-2 chloride currents. Am J Physiol Cell Physiol. 2004;287:C1178–C1183.CrossRef
14.
go back to reference Ueno R, Osama H, Habe T, et al. Oral spi-0211 increases intestinal fluid secretion and chloride concentration without altering serum electrolyte levels (abstract). Gastroenterology. 2004;126:A-100. Ueno R, Osama H, Habe T, et al. Oral spi-0211 increases intestinal fluid secretion and chloride concentration without altering serum electrolyte levels (abstract). Gastroenterology. 2004;126:A-100.
15.
go back to reference Camilleri M, Bharucha AE, Ueno R, et al. Effect of a selective chloride channel activator, lubiprostone, on gastrointestinal transit, gastric sensory, and motor functions in healthy volunteers. Am J Physiol Gastrointes Liver Physiol. 2006;290:G942–G947.CrossRef Camilleri M, Bharucha AE, Ueno R, et al. Effect of a selective chloride channel activator, lubiprostone, on gastrointestinal transit, gastric sensory, and motor functions in healthy volunteers. Am J Physiol Gastrointes Liver Physiol. 2006;290:G942–G947.CrossRef
16.
go back to reference Johanson JF, Morton D, Geenen J, Ueno R. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of lubiprostone, a locally acting type-2 chloride channel activator, in patients with chronic constipation. Am J Gastroenterol. 2008;103:170–177.PubMedCrossRef Johanson JF, Morton D, Geenen J, Ueno R. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of lubiprostone, a locally acting type-2 chloride channel activator, in patients with chronic constipation. Am J Gastroenterol. 2008;103:170–177.PubMedCrossRef
17.
go back to reference Barish CF, Drossman D, Johanson JF, Ueno R. Efficacy and safety of lubiprostone in patients with chronic constipation. Dig Dis Sci. 2010;55:1090–1097.PubMedCrossRef Barish CF, Drossman D, Johanson JF, Ueno R. Efficacy and safety of lubiprostone in patients with chronic constipation. Dig Dis Sci. 2010;55:1090–1097.PubMedCrossRef
18.
go back to reference Johanson JF, Gargano MA, Holland PC, et al. Phase III, randomized withdrawal study of RU-0211, a novel chloride channel activator for the treatment of constipation. Gastroenterology. 2004;126:A-100. Abstract. Johanson JF, Gargano MA, Holland PC, et al. Phase III, randomized withdrawal study of RU-0211, a novel chloride channel activator for the treatment of constipation. Gastroenterology. 2004;126:A-100. Abstract.
20.
go back to reference Rivera E, Wahle A, Joswick TR, et al. Lubiprostone, a novel type-2 chloride channel (ClC-2) activator, does not affect serum electrolyte balance in elderly and non-elderly patients with chronic idiopathic constipation. Gastroenterology. 2007;132:A191–A192. Abstract. Rivera E, Wahle A, Joswick TR, et al. Lubiprostone, a novel type-2 chloride channel (ClC-2) activator, does not affect serum electrolyte balance in elderly and non-elderly patients with chronic idiopathic constipation. Gastroenterology. 2007;132:A191–A192. Abstract.
21.
go back to reference Sprenger C, Copa A, Morganroth J, et al. Effect of lubiprostone, a unique agent for the treatment of chronic idiopathic constipation, on clinical electrocardiographic results. Gastroenterology. 2007;132:A325. Abstract. Sprenger C, Copa A, Morganroth J, et al. Effect of lubiprostone, a unique agent for the treatment of chronic idiopathic constipation, on clinical electrocardiographic results. Gastroenterology. 2007;132:A325. Abstract.
22.
go back to reference Corazziari E, Badiali D, Bazzocchi G, et al. Long-term efficacy, safety, and tolerability of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut. 2000;46:522–526.PubMedCrossRef Corazziari E, Badiali D, Bazzocchi G, et al. Long-term efficacy, safety, and tolerability of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut. 2000;46:522–526.PubMedCrossRef
Metadata
Title
Long-Term Safety and Effectiveness of Lubiprostone, a Chloride Channel (ClC-2) Activator, in Patients with Chronic Idiopathic Constipation
Authors
Anthony J. Lembo
John F. Johanson
Henry P. Parkman
Satish S. Rao
Philip B. Miner Jr.
Ryuji Ueno
Publication date
01-09-2011
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 9/2011
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-011-1801-0

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