PDF(Pubmed)
Abstract：
Objective: Eluxadoline is a newly approved drug for irritable bowel syndrome (IBS), but it has rarely been compared with positive controls. We aimed to compare eluxadoline with antispasmodics in the treatment of IBS. Methods: We searched the OVID Medline, Embase, and the Cochrane Central Register of Controlled Trials databases for randomized controlled trials (RCTs) comparing eluxadoline or antispasmodics with placebo. The search was conducted from 1 January 1980, to 1 September 2020, without any language restrictions. The primary efficacy outcome was the relief of abdominal pain, defined by a reduction of pain scores of at least 30% from baseline. The secondary efficacy outcome was the relief of global IBS symptoms, defined by a composite response of a decrease in abdominal pain and improvement in stool consistency on the same day for at least 50% of the days assessed. The data were pooled using a random-effects model. Outcome estimates were pooled by using Risk Ratios (RRs) and P-scores. Results: Forty-two trials with 8,457 participants were included from 45 articles. Compared with placebo, each of drotaverine, pinaverium, alverine combined with simethicone (ACS) and eluxadoline 100 mg was highly effective in the relief of abdominal pain, with drotaverine [RR, 2.71 (95% CI, 1.70 to 4.32), P-score = 0.95] ranking first. Drotaverine, otilonium, cimetropium, pinaverium, and eluxadoline 100 mg had significantly high the relief of global IBS symptomss, for which drotaverine [RR, 2.45 (95% CI, 1.42 to 4.22), P-score = 0.95] was ranked first. No significant difference was found between these interventions. Pinaverium had a significantly higher the relief of global IBS symptoms than eluxadoline [RR, 1.72 (95% CI, 1.33 to 2.21)] on sensitivity analysis. However, no significant difference was found in the number of adverse events between each intervention and the placebo. Conclusion: Our network meta-analysis showed that eluxadoline 100 mg was at least as effective as antispasmodics in relieving abdominal pain in IBS. But eluxadoline had more reported adverse events. Antispasmodics are still the first choice for the treatment of IBS.
摘要：
目的:依鲁克多啉是一种新批准的治疗肠易激综合征(IBS)的药物,但很少与阳性对照进行比较。我们旨在比较利沙多林与抗痉挛药在IBS治疗中的作用。方法：我们搜索了OVIDMedline，Embase,和Cochrane中央对照试验注册数据库，用于比较eloxadoline或抗痉挛药与安慰剂的随机对照试验（RCT）。搜索于1980年1月1日至2020年9月1日进行，没有任何语言限制。主要疗效结果是腹痛的缓解，定义为疼痛评分比基线降低至少30%。次要疗效结果是整体IBS症状的缓解，定义为至少50％的评估天在同一天减少腹痛和改善粪便稠度的复合反应。使用随机效应模型汇集数据。结果估计值通过使用风险比(RR)和P评分进行汇总。结果：从45篇文章中纳入了42项试验，共有8,457名参与者。与安慰剂相比，每个drotaverine,Pinaverium,阿尔维林联合西甲硅油（ACS）和eloxadoline100mg在缓解腹痛方面非常有效，与drotaverine[RR，2.71（95%CI，1.70至4.32），P-score=0.95]排名第一。Drotaverine,奥替林,西美托,Pinaverium,和依洛沙多林100毫克有明显高的整体IBS症状的缓解，对于哪个drotaverine[RR，2.45（95%CI，1.42至4.22），P分数=0.95]排名第一。这些干预措施之间没有发现显着差异。Pinaverium对全球IBS症状的缓解明显高于依洛沙多林[RR，敏感性分析为1.72（95%CI，1.33至2.21）]。然而,各干预措施与安慰剂组的不良事件数无显著差异.结论：我们的网络荟萃分析显示，在缓解IBS的腹痛方面，乐沙多林100mg至少与抗痉挛药一样有效。但是伊洛沙多林有更多的不良事件报道。抗痉挛仍是治疗IBS的首选药物。
